Active NPI
Sydney Phelan, DPT
- Physical Therapist
- Southfield, MI
National Provider Identifier
1265157945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501301956
- Practice address
- 22255 Greenfield Rd
Southfield, MI 48075-3710 - Phone
- (248) 849-2410
- NPI assigned
- Oct 5, 2022
- Last updated
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 5501301956 | MI | Primary |
Addresses
Primary practice location
22255 Greenfield Rd
Southfield, MI 48075-3710
Mailing address
192 Fabius Dr
Troy, MI 48098-3037
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 |
|---|---|---|---|
| 5501301956 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1265157945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 FABIUS DR",
"city": "TROY",
"state": "MI",
"postal_code": "480983037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22255 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480753710",
"telephone_number": "248-849-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELAN",
"first_name": "SYDNEY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501301956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.