Individual provider Active NPI

Prachi Doke Bhole

  • Physical Therapist
  • Waterford, MI
National Provider Identifier
1295073328
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014756 Issued in MI
Practice address
5601 Hatchery Rd
Waterford, MI 48329-3451
Phone
(248) 674-5367
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 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 5501014756 MI Primary

Addresses

Primary practice location

5601 Hatchery Rd
Waterford, MI 48329-3451

Mailing address

21210 Thornridge Dr
Grand Blanc, MI 48439-9255
Phone (248) 636-3941

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

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1295073328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21210 THORNRIDGE DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399255",
            "telephone_number": "248-636-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 HATCHERY RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293451",
            "telephone_number": "248-674-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKE BHOLE",
        "first_name": "PRACHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.