Individual provider Active NPI

Trisha Meddaugh, PTA

  • Physical Therapist
  • Lansing, MI
National Provider Identifier
1487321865
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5502006109 Issued in MI
Practice address
1568 Lake Lansing Rd Ste B
Lansing, MI 48912-3707
Phone
(517) 483-2734
NPI assigned
Aug 24, 2021
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5502006109 MI Primary

Addresses

Primary practice location

1568 Lake Lansing Rd Ste B
Lansing, MI 48912-3707

Mailing address

1568 Lake Lansing Rd Ste B
Lansing, MI 48912-3707
Phone (517) 483-2734

Other identifiers 1

IdentifierTypeStateIssuer
5502006109OtherMISTATE PTA LICENSE

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

LicenseStateTypeSpecialty
5502006109MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Center at Allure Medical Spa, PLLC CurrentSince Aug 29, 2021 Accepting new patients
Lansing Rehabilitation Services, P.C. Physical Therapist CurrentSince Aug 29, 2021 Accepting new patients

Locations

1568 Lake Lansing Rd
Ste B
Lansing, MI 48912
Phone (517) 483-2734

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1487321865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 LAKE LANSING RD STE B",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123707",
            "telephone_number": "517-483-2734",
            "fax_number": "517-483-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 LAKE LANSING RD STE B",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123707",
            "telephone_number": "517-483-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDDAUGH",
        "first_name": "TRISHA",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5502006109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PTA LICENSE",
            "identifier": "5502006109",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.