Individual provider Active NPI

Jacalyn Christman

  • Physical Therapy Assistant
  • Farmington Hills, MI
National Provider Identifier
1396930822
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06001666A Issued in IN
Practice address
27240 Haggerty Rd
E-15
Farmington Hills, MI 48331-5716
Phone
(866) 991-0900
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06001666A IN Primary
Physical Therapy Assistant 225200000X 2002013877 MO

Addresses

Primary practice location

27240 Haggerty Rd
E-15
Farmington Hills, MI 48331-5716

Mailing address

107 Bee Hive TRL Lot 207
Hollister, MO 65672-5744

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
06001666AINMDPhysical Therapy Assistant
2002013877MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1396930822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BEE HIVE TRL LOT 207",
            "city": "HOLLISTER",
            "state": "MO",
            "postal_code": "656725744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27240 HAGGERTY RD",
            "address_2": "E-15",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315716",
            "telephone_number": "866-991-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTMAN",
        "first_name": "JACALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06001666A",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2002013877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.