Active NPI
Michelle Kazmier
- Sports Physical Therapist
- Phoenix, AZ
National Provider Identifier
1487209730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 31717
- Practice address
- 2629 E Rose Garden LN
Phoenix, AZ 85050-4605 - Phone
- (412) 673-5005
- NPI assigned
- Aug 5, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 296648 | CA | |
| Sports Physical Therapist | 2251S0007X | 31717 | AZ | Primary |
| Physical Therapist | 225100000X | PT027727 | PA |
Addresses
Primary practice location
2629 E Rose Garden LN
Phoenix, AZ 85050-4605
Mailing address
2629 E Rose Garden LN
Phoenix, AZ 85050-4605
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 |
|---|---|---|---|
| 31717 | AZ | MD | Emergency Medicine Physician |
| PT027727 | PA | MD | Physical Therapist |
| 296648 | CA | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1487209730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2629 E ROSE GARDEN LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2629 E ROSE GARDEN LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504605",
"telephone_number": "412-673-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZMIER",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "296648",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "AZ",
"license": "31717",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT027727",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.