Individual provider Active NPI

Michelle Newsome, PT

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1215054333
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05001097A Issued in IN
Practice address
5068 Robinsrock Way
Indianapolis, IN 46268-4009
Phone
(317) 250-8896
Fax
(317) 466-2000
NPI assigned
Mar 23, 2007
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05001097A IN Primary

Addresses

Primary practice location

5068 Robinsrock Way
Indianapolis, IN 46268-4009

Mailing address

5068 Robinsrock Way
Indianapolis, IN 46268-4009
Phone (317) 466-1000

Other identifiers 1

IdentifierTypeStateIssuer
100462120MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05001097AINMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1215054333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5068 ROBINSROCK WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462684009",
            "telephone_number": "317-466-1000",
            "fax_number": "317-466-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5068 ROBINSROCK WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462684009",
            "telephone_number": "317-250-8896",
            "fax_number": "317-466-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOME",
        "first_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001097A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100462120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.