Active NPI
Michelle Menzer, MPT
- Specialist
- Newark, DE
National Provider Identifier
1497902605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- JI-0000863
- Practice address
- 102 W Mill Station Dr
Newark, DE 19711-7484 - Phone
- (302) 366-7456
- NPI assigned
- Aug 20, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | JI-0000863 | DE | Primary |
Addresses
Primary practice location
102 W Mill Station Dr
Newark, DE 19711-7484
Mailing address
102 W Mill Station Dr
Newark, DE 19711-7484
Phone (302) 366-7456
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 |
|---|---|---|---|
| JI-0000863 | DE | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219190400000",
"number": "1497902605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 W MILL STATION DR",
"city": "NEWARK",
"state": "DE",
"postal_code": "197117484",
"telephone_number": "302-366-7456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 W MILL STATION DR",
"city": "NEWARK",
"state": "DE",
"postal_code": "197117484",
"telephone_number": "302-366-7456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENZER",
"first_name": "MICHELLE",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2008-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "DE",
"license": "JI-0000863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.