Active NPI
Michelle Lynn Randall, LPTA
- Physical Therapy Assistant
- Troy, OH
National Provider Identifier
1265962492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10346
- Practice address
- 512 Crescent Dr
Troy, OH 45373-2718 - Phone
- (937) 335-7161
- NPI assigned
- Jun 20, 2017
- 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 Therapy Assistant | 225200000X | 10346 | OH | Primary |
Addresses
Primary practice location
512 Crescent Dr
Troy, OH 45373-2718
Mailing address
355 Bobbitt Rd
Wilmington, OH 45177-7525
Phone (937) 552-6097
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 |
|---|---|---|---|
| 10346 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1265962492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BOBBITT RD",
"city": "WILMINGTON",
"state": "OH",
"postal_code": "451777525",
"telephone_number": "937-552-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 CRESCENT DR",
"city": "TROY",
"state": "OH",
"postal_code": "453732718",
"telephone_number": "937-335-7161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-20",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "10346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.