The Michanic Shop, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THE MICHANIC SHOP, LLC

Practice address

6428 Ruxton LN
Austin, TX 78749-4126

Phone

(915) 412-2734

NPI assigned

Sep 3, 2021

Organization subpart

No

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

Authorized official

Name

Michael GillespieNPI 1861746273

Title

Physical Therapist

Phone

(915) 412-2734

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Gillespie, PT, DPT

  • Physical Therapist
  • Schertz, TX
  • NPI 1861746273
  NPD Authorized official

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1265100192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 OLD FREDERICKSBURG RD # 92946",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6428 RUXTON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494126",
            "telephone_number": "915-412-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MICHANIC SHOP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "GILLESPIE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "915-412-2734"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.