Active NPI
Patrick Joseph Christianson, P.T.
- Physical Therapist
- South Bend, IN
National Provider Identifier
1427070697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05004061A
- Practice address
- 53880 Carmichael Dr
South Bend, IN 46635-1567 - Phone
- (574) 247-9441
- NPI assigned
- Jul 24, 2006
- Last updated
- Mar 22, 2017
- 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 | 05004061A | IN | Primary |
Addresses
Primary practice location
53880 Carmichael Dr
South Bend, IN 46635-1567
Mailing address
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone (574) 247-9441
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 |
|---|---|---|---|
| 05004061A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Esi Consulting LLC | Current | Accepting new patients | |
| Body One Health and Fitness Center, LLC | Physical Therapist | Past | Accepting new patients |
| South Bend Orthopaedic Associates, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/13070/brand/2/csg/1/fhir/r4
Organizations & group practices 3
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.
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- NPI 1871364919
-
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- Indianapolis, IN
- NPI 1528092442
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1669421277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490140800000",
"number": "1427070697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53880 CARMICHAEL DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351567",
"telephone_number": "574-247-9441",
"fax_number": "574-247-9442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53880 CARMICHAEL DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351567",
"telephone_number": "574-247-9441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSON",
"first_name": "PATRICK",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2017-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05004061A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.