Individual provider Active NPI

Christina Henriquez, DPT

  • Physical Therapist
  • Fenton, MI
National Provider Identifier
1386023695
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017211 Issued in MI
Practice address
3240 W Silver Lake Rd
Fenton, MI 48430-1374
Phone
(810) 714-4616
NPI assigned
May 20, 2015
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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 5501017211 MI Primary

Addresses

Primary practice location

3240 W Silver Lake Rd
Fenton, MI 48430-1374

Mailing address

6067 Maple TRL
Grand Blanc, MI 48439-9040
Phone (248) 467-1470

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

State licenses

LicenseStateTypeSpecialty
5501017211MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc PastSince Jun 12, 2022 Accepting new patients
Physiotherapy Associates Inc PastSince Jun 12, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1386023695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6067 MAPLE TRL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399040",
            "telephone_number": "248-467-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 W SILVER LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301374",
            "telephone_number": "810-714-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "CHRISTINA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017211",
            "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 Jun 6, 2022; 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.