Adeyinka Mark Fagbamila, B.SC RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501009139 Issued in MI

Practice address

20510 Fenkell St
Detroit, MI 48223-1613

Phone

(313) 534-6611

NPI assigned

Aug 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Francrachel (U.S.a) L.L.C

  • Physical Therapist
  • Southfield, MI
  • NPI 1801905443
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437267556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26696 ISLEWORTH PT",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345670",
            "telephone_number": "313-492-1946",
            "fax_number": "248-799-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20510 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482231613",
            "telephone_number": "313-534-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBAMILA",
        "first_name": "ADEYINKA",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "B.SC  RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4693548",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Fadlallah
• Alexis Leigh Fagan-Williams
• Fallon Fagan
• Thomas Fagan
• Angela M Fagans
• Karen A. Fagin, M.D.
• Sheikh Muhammad Faheem, MD
• Humaira Fahim, M.D.
• Kamal Fahim, MD
• Stefani Maher Faik, BA

• Physical Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.