Active NPI
Marc Adam Plizga, ATC
- Athletic Trainer
- Clarkston, MI
National Provider Identifier
1477579878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 6770 Dixie Hwy
Suite 104
Clarkston, MI 48346-2087 - Phone
- (248) 625-5998
- Fax
- (248) 625-3975
- NPI assigned
- Jul 15, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
6770 Dixie Hwy
Suite 104
Clarkston, MI 48346-2087
Mailing address
6173 Tyler Woods TRL
White Lake, MI 48383-1972
Phone (248) 625-5998
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477579878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6173 TYLER WOODS TRL",
"city": "WHITE LAKE",
"state": "MI",
"postal_code": "483831972",
"telephone_number": "248-625-5998",
"fax_number": "248-625-3975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6770 DIXIE HWY",
"address_2": "SUITE 104",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483462087",
"telephone_number": "248-625-5998",
"fax_number": "248-625-3975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLIZGA",
"first_name": "MARC",
"middle_name": "ADAM",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, MI
Sources for this page
- 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.