Active NPI
Michael Allen Fann, MPT
- Physical Therapist
- Salisbury, NC
National Provider Identifier
1538330626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11490
- Practice address
- 710 Julian Rd
Salisbury, NC 28147-9079 - Phone
- (704) 636-5812
- NPI assigned
- Mar 17, 2008
- 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 | 11490 | NC | Primary |
Addresses
Primary practice location
710 Julian Rd
Salisbury, NC 28147-9079
Mailing address
254 Huntingdon Rd
Lexington, NC 27295-7427
Phone (910) 639-3392
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 |
|---|---|---|---|
| 11490 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1538330626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 HUNTINGDON RD",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272957427",
"telephone_number": "910-639-3392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 JULIAN RD",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281479079",
"telephone_number": "704-636-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANN",
"first_name": "MICHAEL",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.