Individual provider Active NPI

Beth Addesso, MS, CES

  • Clinical Exercise Physiologist
  • Rochester Hills, MI
National Provider Identifier
1306200019
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
License
532835 Issued in MI
Practice address
1135 W University Dr
Suite 250
Rochester Hills, MI 48307-1871
Phone
(248) 453-0170
Fax
(248) 453-0211
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X 532835 MI Primary

Addresses

Primary practice location

1135 W University Dr
Suite 250
Rochester Hills, MI 48307-1871

Mailing address

1135 W University Dr
Suite 250
Rochester Hills, MI 48307-1871
Phone (248) 453-0170

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
532835MIMDClinical Exercise Physiologist

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1306200019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR",
            "address_2": "SUITE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071871",
            "telephone_number": "248-453-0170",
            "fax_number": "248-453-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR",
            "address_2": "SUITE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071871",
            "telephone_number": "248-453-0170",
            "fax_number": "248-453-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDESSO",
        "first_name": "BETH",
        "credential": "MS, CES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "MI",
            "license": "532835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.