Active NPI
Micheline Champagne
- Orthopedic Physical Therapist
- Randolph, MA
National Provider Identifier
1326094889
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Sep 20, 2011.
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 13242
- Practice address
- 999 N Main St
Randolph, MA 02368-3072 - Phone
- (781) 963-1697
- Fax
- (781) 963-5770
- NPI assigned
- May 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 13242 | MA | Primary |
Addresses
Primary practice location
999 N Main St
Randolph, MA 02368-3072
Mailing address
212 Page St
Avon, MA 02322-1211
Phone (508) 427-5512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y67978 | Other | MA | BLUE CROSS BLUE SHIELD |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
Interoperability endpoints
- https://api.platform.athenahealth.com/25763/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1326094889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 PAGE ST",
"city": "AVON",
"state": "MA",
"postal_code": "023221211",
"telephone_number": "508-427-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 N MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023683072",
"telephone_number": "781-963-1697",
"fax_number": "781-963-5770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "MICHELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "13242",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y67978",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.