Active NPI
Clemence Dejesus Aguila, PHYSICAL THERAPIST
- Physical Therapist
- Sterling Heights, MI
National Provider Identifier
1497044812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501013043
- Practice address
- 13439 E 14 Mile Rd
Sterling Heights, MI 48312-6304 - Phone
- (586) 977-3900
- Fax
- (586) 977-6084
- NPI assigned
- Apr 6, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501013043 | MI | Primary |
Addresses
Primary practice location
13439 E 14 Mile Rd
Sterling Heights, MI 48312-6304
Mailing address
13439 E 14 Mile Rd
Sterling Heights, MI 48312-6304
Phone (586) 977-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501013043 | Other | MI | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501013043 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1497044812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13439 E 14 MILE RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483126304",
"telephone_number": "586-977-3900",
"fax_number": "586-977-6084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13439 E 14 MILE RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483126304",
"telephone_number": "586-977-3900",
"fax_number": "586-977-6084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGUILA",
"first_name": "CLEMENCE",
"middle_name": "DEJESUS",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-06",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501013043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "5501013043",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.