Individual provider Active NPI

Alan Fredendall, DPT

  • Physical Therapist
  • Fenton, MI
National Provider Identifier
1326563602
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
14261 Torrey Rd Ste C
Fenton, MI 48430-3329
Phone
(810) 354-5380
Fax
(810) 885-8291
NPI assigned
Aug 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 Primary

Addresses

Primary practice location

14261 Torrey Rd Ste C
Fenton, MI 48430-3329

Mailing address

14261 Torrey Rd Ste C
Fenton, MI 48430-3329
Phone (810) 354-5380

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fitnesstx, PLLC Physical Therapist CurrentSince Jun 16, 2019 Accepting new patients

Locations

14261 Torrey Rd
Ste C
Fenton, MI 48430
Phone (810) 354-5380

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1326563602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14261 TORREY RD STE C",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303329",
            "telephone_number": "810-354-5380",
            "fax_number": "810-885-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14261 TORREY RD STE C",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303329",
            "telephone_number": "810-354-5380",
            "fax_number": "810-885-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDENDALL",
        "first_name": "ALAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.