Physical Therapist

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39149 Issued in CA

Legal business name

PHYSICAL THERAPIST

Practice address

2614 Jasmine St
National City, CA 91950-6253

Phone

(480) 577-1398

NPI assigned

Sep 25, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Michelle E Lacey, DPT

Title

Physical Therapist

Phone

(480) 577-1398

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1326440934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 JASMINE ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919506253",
            "telephone_number": "480-577-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 JASMINE ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919506253",
            "telephone_number": "480-577-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "480-577-1398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in National City, CA
• Providers in National City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.