Active NPI
Addison Ouellette
- Physical Therapy Assistant
- Rockford, MI
National Provider Identifier
1396286175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 9215 Booth Bay CT. NE
Rockford, MI 49341-7386 - Phone
- (616) 481-0747
- NPI assigned
- Mar 14, 2017
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Primary |
Addresses
Primary practice location
9215 Booth Bay CT. NE
Rockford, MI 49341-7386
Mailing address
9215 Booth Bay CT NE
Rockford, MI 49341-7386
Phone (616) 481-0747
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1396286175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9215 BOOTH BAY CT NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493417386",
"telephone_number": "616-481-0747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9215 BOOTH BAY CT. NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493417386",
"telephone_number": "616-481-0747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUELLETTE",
"first_name": "ADDISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-14",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.