Active NPI
Charu Smita Gupta, PT
- Physical Therapist
- Troy, MI
National Provider Identifier
1457596041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501012307
- Practice address
- 4932 Carlson Park Dr
Troy, MI 48098-7102 - Phone
- (734) 752-7682
- NPI assigned
- Dec 10, 2008
- Sex
- Female
- 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 | 5501012307 | MI | Primary |
Addresses
Primary practice location
4932 Carlson Park Dr
Troy, MI 48098-7102
Mailing address
4932 Carlson Park Dr
Troy, MI 48098-7102
Phone (734) 752-7682
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 |
|---|---|---|---|
| 5501012307 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1457596041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4932 CARLSON PARK DR",
"city": "TROY",
"state": "MI",
"postal_code": "480987102",
"telephone_number": "734-752-7682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4932 CARLSON PARK DR",
"city": "TROY",
"state": "MI",
"postal_code": "480987102",
"telephone_number": "734-752-7682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "CHARU",
"middle_name": "SMITA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-10",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.