Renee Fricke, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501002842 Issued in MI

Practice address

18899 W 12 Mile Rd Ste 101
Lathrup Village, MI 48076-2541

Phone

(248) 210-4172

NPI assigned

Feb 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Hands-on Physical Therapy and Athletic Rehabilitation Center LLC

  • Physical Therapist
  • Lathrup Village, MI
  • NPI 1588084263
  NPD (past)

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1518325307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18831 SARATOGA BLVD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480767816",
            "telephone_number": "248-210-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18899 W 12 MILE RD STE 101",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762541",
            "telephone_number": "248-210-4172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47220 W 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483742932",
            "country_code": "US",
            "telephone_number": "248-707-5443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33233 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "MI",
            "postal_code": "480090903",
            "country_code": "US",
            "telephone_number": "248-792-2310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18899 W 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Lathrup Village",
            "state": "MI",
            "postal_code": "480762541",
            "country_code": "US",
            "telephone_number": "248-552-0205",
            "fax_number": "248-552-0256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "RENEE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501002842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fortson Dental, P.C.
• Fortson Dentistry Lathrup North
• Fortson Family Dentistry, P.C.
• Payaum Fotovat-Ahmadi, MD
• Erin Lee Fox, R.D.
• Hadassah Friedman
• Ashantae La'Nee' Gary
• Nelvita Gavin
• Louis Jeremy Geller, D.P.M.
• Gentle Touch Dentistry P.C.

• Massage Therapist in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.