Traci Marie Osburn, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011058 Issued in MI

Practice address

730 Riverside Ave
Adrian, MI 49221-1445

Phone

(517) 266-1700

Fax

(517) 266-1800

NPI assigned

Nov 8, 2018

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1447728209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 BAKER HWY",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492219657",
            "telephone_number": "517-513-9989",
            "fax_number": "517-266-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211445",
            "telephone_number": "517-266-1700",
            "fax_number": "517-266-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBURN",
        "first_name": "TRACI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501011058",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omega Youth Empowerment, PLLC
• Jessica Marie Opel
• Open Fields Mental Health, PLLC
• Brooke Catherine Osborn
• Amanda Megan Osburn, BSW
• Jason Osstifin, MSW
• Natalie Jeane Ost
• Jeffrey R Osworth, PA
• Josephine A Pabalan, M.D.
• Jonelle Pace

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.