Active NPI
Miranda Filicity Martin, PT
- Physical Therapist
- Dearborn, MI
National Provider Identifier
1245429927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501007859
- Practice address
- 3001 Miller Rd
Dearborn, MI 48120-1458 - Phone
- (313) 594-1653
- Fax
- (313) 594-9797
- NPI assigned
- Oct 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501007859 | MI | Primary |
Addresses
Primary practice location
3001 Miller Rd
Dearborn, MI 48120-1458
Mailing address
3001 Miller Rd
Dearborn, MI 48120-1458
Phone (313) 594-1653
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501007859 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1245429927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 MILLER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201458",
"telephone_number": "313-594-1653",
"fax_number": "313-594-9797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 MILLER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201458",
"telephone_number": "313-594-1653",
"fax_number": "313-594-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MIRANDA",
"middle_name": "FILICITY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-18",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501007859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.