Active NPI
Bethany Joy Codrean, PT
- Physical Therapist
- Lapeer, MI
National Provider Identifier
1245837079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501019719
- Practice address
- 1794 N Lapeer Rd Ste C
Lapeer, MI 48446-7664 - Phone
- (810) 664-3000
- Fax
- (810) 664-9775
- NPI assigned
- Oct 5, 2020
- 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 | 5501019719 | MI | Primary |
Addresses
Primary practice location
1794 N Lapeer Rd Ste C
Lapeer, MI 48446-7664
Mailing address
1794 N Lapeer Rd Ste C
Lapeer, MI 48446-7664
Phone (810) 664-3000
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1245837079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1794 N LAPEER RD STE C",
"city": "LAPEER",
"state": "MI",
"postal_code": "484467664",
"telephone_number": "810-664-3000",
"fax_number": "810-664-9775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1794 N LAPEER RD STE C",
"city": "LAPEER",
"state": "MI",
"postal_code": "484467664",
"telephone_number": "810-664-3000",
"fax_number": "810-664-9775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CODREAN",
"first_name": "BETHANY",
"middle_name": "JOY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-05",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501019719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.