Individual provider Active NPI

Christina Jo Planck, PTA

  • Physical Therapy Assistant
  • Canton, MI
National Provider Identifier
1306161864
Registry record updated Mar 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502001588 Issued in MI
Practice address
222 Princess Dr
Canton, MI 48188-1142
Phone
(734) 981-4821
NPI assigned
Mar 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502001588 MI Primary

Addresses

Primary practice location

222 Princess Dr
Canton, MI 48188-1142

Mailing address

222 Princess Dr
Canton, MI 48188-1142
Phone (734) 981-4821

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
5502001588MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1269734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269734400000",
    "number": "1306161864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PRINCESS DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881142",
            "telephone_number": "734-981-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PRINCESS DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881142",
            "telephone_number": "734-981-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANCK",
        "first_name": "CHRISTINA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-28",
        "last_updated": "2010-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502001588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2010; 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.