Active NPI
Michele A Lucien, PTA
- Physical Therapy Assistant
- Jackson, GA
National Provider Identifier
1477030971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA003011
- Practice address
- 1050 McDonough Rd
Jackson, GA 30233-1524 - Phone
- (770) 775-7861
- NPI assigned
- Jul 26, 2018
- 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 Therapy Assistant | 225200000X | PTA003011 | GA | Primary |
Addresses
Primary practice location
1050 McDonough Rd
Jackson, GA 30233-1524
Mailing address
1050 McDonough Rd
Jackson, GA 30233-1524
Phone (770) 775-7861
Other names 1
- Michele A Hallman
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA003011 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532563200000",
"number": "1477030971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 MCDONOUGH RD",
"city": "JACKSON",
"state": "GA",
"postal_code": "302331524",
"telephone_number": "770-775-7861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 MCDONOUGH RD",
"city": "JACKSON",
"state": "GA",
"postal_code": "302331524",
"telephone_number": "770-775-7861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCIEN",
"first_name": "MICHELE",
"middle_name": "A",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-26",
"last_updated": "2018-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA003011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELE",
"last_name": "HALLMAN",
"middle_name": "A",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jackson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.