Active NPI
Renee Alison Halladay, PTA
- Physical Therapy Assistant
- Mount Pleasant, MI
National Provider Identifier
1487218780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5502001629
- Practice address
- 400 S Crapo St
Mount Pleasant, MI 48858-2944 - Phone
- (989) 773-5918
- NPI assigned
- Apr 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 5502001629 | MI | Primary |
Addresses
Primary practice location
400 S Crapo St
Mount Pleasant, MI 48858-2944
Mailing address
400 S Crapo St
Mount Pleasant, MI 48858-2944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5502001629 | Medicaid | MI |
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 |
|---|---|---|---|
| 5502001629 | MI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1487218780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S CRAPO ST",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488582944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S CRAPO ST",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488582944",
"telephone_number": "989-773-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLADAY",
"first_name": "RENEE",
"middle_name": "ALISON",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502001629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5502001629",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.