Individual provider Active NPI

Pierre Luyckx, DPT

  • Physical Therapist
  • Saint Joseph, MI
National Provider Identifier
1356424675
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007604 Issued in MI
Practice address
2800 Niles Rd
Saint Joseph, MI 49085-3317
Phone
(269) 408-1994
Fax
(269) 408-1946
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 5501007604 MI Primary

Addresses

Primary practice location

2800 Niles Rd
Saint Joseph, MI 49085-3317

Mailing address

2746 Sanctuary Dr
Stevensville, MI 49127-8313
Phone (269) 556-0881

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

State licenses

LicenseStateTypeSpecialty
5501007604MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356424675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 SANCTUARY DR",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491278313",
            "telephone_number": "269-556-0881",
            "fax_number": "269-556-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853317",
            "telephone_number": "269-408-1994",
            "fax_number": "269-408-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUYCKX",
        "first_name": "PIERRE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.