Active NPI
James P Michalik, PT
- Physical Therapist
- Knoxville, TN
National Provider Identifier
1487651089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT634
- Practice address
- 6700 Baum Dr
Ste 19
Knoxville, TN 37919-7334 - Phone
- (865) 588-4108
- Fax
- (865) 474-1521
- NPI assigned
- Jun 29, 2005
- Last updated
- May 18, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT634 | TN | Primary |
Addresses
Primary practice location
6700 Baum Dr
Ste 19
Knoxville, TN 37919-7334
Mailing address
6700 Baum Dr
Ste 19
Knoxville, TN 37919-7334
Phone (865) 588-4108
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0166930001 | Other | TN | DURABLE MED EQUIP MEDICAR |
| 650008553 | Other | TN | RAILROAD MEDICARE |
| 3654677 | Medicaid | TN | |
| 0025925 | Other | TN | BLUE CROSS BLUE SHIELD |
| TN0101 | Other | TN | JOHN DEERE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT634 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337299200000",
"number": "1487651089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 BAUM DR",
"address_2": "STE 19",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379197334",
"telephone_number": "865-588-4108",
"fax_number": "865-474-1521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 BAUM DR",
"address_2": "STE 19",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379197334",
"telephone_number": "865-588-4108",
"fax_number": "865-474-1521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHALIK",
"first_name": "JAMES",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-29",
"last_updated": "2012-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT634",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DURABLE MED EQUIP MEDICAR",
"identifier": "0166930001",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "650008553",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3654677",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0025925",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN0101",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.