Active NPI
Allen Satoshi Potter, DPT
- Physical Therapist
- Madison Heights, MI
National Provider Identifier
1396409256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501020137
- Practice address
- 1433 E 12 Mile Rd
Madison Heights, MI 48071-2653 - Phone
- (248) 658-2110
- Fax
- (248) 658-2111
- NPI assigned
- Oct 27, 2021
- Sex
- Male
- 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 Therapist | 225100000X | 5501020137 | MI | Primary |
Addresses
Primary practice location
1433 E 12 Mile Rd
Madison Heights, MI 48071-2653
Mailing address
33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501020137 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1396409256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33900 HARPER AVE STE 104",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480354258",
"telephone_number": "586-350-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 E 12 MILE RD",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480712653",
"telephone_number": "248-658-2110",
"fax_number": "248-658-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "ALLEN",
"middle_name": "SATOSHI",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-27",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501020137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.