Active NPI
Andrew Todd Priestap
- Physical Therapist
- Grand Blanc, MI
National Provider Identifier
1285657361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501010469
- Practice address
- 6136 Pine Creek CT
Grand Blanc, MI 48439-9768 - Phone
- (810) 247-2003
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- 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 Therapist | 225100000X | 5501010469 | MI | Primary |
Addresses
Primary practice location
6136 Pine Creek CT
Grand Blanc, MI 48439-9768
Mailing address
6136 Pine Creek CT
Grand Blanc, MI 48439-9768
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00321187 | Other | MI | RAILROAD |
| 650B514090 | Other | MI | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010469 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551398400000",
"number": "1285657361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6136 PINE CREEK CT",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484399768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6136 PINE CREEK CT",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484399768",
"telephone_number": "810-247-2003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIESTAP",
"first_name": "ANDREW",
"middle_name": "TODD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2019-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010469",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00321187",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "650B514090",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.