Individual provider Active NPI

Colin Alan Worden, LPTA

  • Physical Therapy Assistant
  • Caro, MI
National Provider Identifier
1407410558
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502005818 Issued in MI
Practice address
1285 Cleaver Rd
Caro, MI 48723-9241
Phone
(989) 673-4117
NPI assigned
Apr 24, 2019
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502005818 MI Primary

Addresses

Primary practice location

1285 Cleaver Rd
Caro, MI 48723-9241

Mailing address

2600 Compass Rd
Glenview, IL 60026-8001
Phone (877) 787-3430

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
5502005818MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1407410558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "877-787-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 CLEAVER RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239241",
            "telephone_number": "989-673-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEN",
        "first_name": "COLIN",
        "middle_name": "ALAN",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.