Individual provider Active NPI

Michelle Alonzo Discaya

  • Physical Therapist
  • Carbondale, IL
National Provider Identifier
1285066183
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07001984 Issued in IL
Practice address
405 West Jackson St.
Memorial Hospital of Carbondale
Carbondale, IL 62901-1462
Phone
(618) 529-0516
Fax
(618) 529-0403
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07001984 IL Primary

Addresses

Primary practice location

405 West Jackson St.
Memorial Hospital of Carbondale
Carbondale, IL 62901-1462

Mailing address

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 529-0516

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

LicenseStateTypeSpecialty
07001984ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1285066183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-529-0516",
            "fax_number": "618-529-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 WEST JACKSON ST.",
            "address_2": "MEMORIAL HOSPITAL OF CARBONDALE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-529-0516",
            "fax_number": "618-529-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISCAYA",
        "first_name": "MICHELLE",
        "middle_name": "ALONZO",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "07001984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.