Individual provider Active NPI

Kristina Michelle Tennant, OTR/MPT

  • Physical Therapist
  • Lansing, MI
National Provider Identifier
1558855668
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501009229 Issued in MI
Practice address
1215 E Michigan Ave FL 6
Lansing, MI 48912-1811
Phone
(517) 364-3375
Fax
(517) 485-1961
NPI assigned
Jun 21, 2018
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501009229 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave FL 6
Lansing, MI 48912-1811

Mailing address

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-3375

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

LicenseStateTypeSpecialty
5501009229MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1558855668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-3375",
            "fax_number": "517-485-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE FL 6",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-3375",
            "fax_number": "517-485-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "KRISTINA",
        "middle_name": "MICHELLE",
        "credential": "OTR/MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.