Michelle Havice Conlin, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6380 Issued in CO

Practice address

1919 65TH Ave Ste 3
Greeley, CO 80634

Phone

(970) 302-4322

Fax

(888) 432-0938

NPI assigned

Nov 19, 2008

Last updated

May 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Michelle Havice Former name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gaia Physical Therapy

  • Physical Therapist
  • Greeley, CO
  • NPI 1467753483
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1265687180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 65TH AVE STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347965",
            "telephone_number": "970-302-4322",
            "fax_number": "888-432-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 65TH AVE STE 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-302-4322",
            "fax_number": "888-432-0938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1136 E Stuart St Ste 2120",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805251197",
            "country_code": "US",
            "telephone_number": "970-302-4322",
            "fax_number": "888-432-0938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "MICHELLE",
        "middle_name": "HAVICE",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "6380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HAVICE",
            "middle_name": "MICHELLE",
            "credential": "M.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dawn Michelle Conley, OTR/L
• Ruth Elizabeth Conley, NP-C
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• Connections for Independent Living
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• Connections for Independent Living
• Dimitri Scott Connell

• Physical Therapist in Greeley, CO
• Providers in Greeley, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.