Active NPI
Renee Michele Lang, PTA
- Physical Therapy Assistant
- Gladwin, MI
National Provider Identifier
1568009959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5502003866
- Practice address
- 449 Quarter St
Gladwin, MI 48624-1918 - Phone
- (989) 426-3430
- NPI assigned
- Dec 4, 2019
- Last updated
- Dec 4, 2019
- 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 Therapy Assistant | 225200000X | 5502003866 | MI | Primary |
Addresses
Primary practice location
449 Quarter St
Gladwin, MI 48624-1918
Mailing address
3009 Calhoun Rd
Beaverton, MI 48612-9775
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 |
|---|---|---|---|
| 5502003866 | MI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1568009959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 CALHOUN RD",
"city": "BEAVERTON",
"state": "MI",
"postal_code": "486129775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "449 QUARTER ST",
"city": "GLADWIN",
"state": "MI",
"postal_code": "486241918",
"telephone_number": "989-426-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "RENEE",
"middle_name": "MICHELE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502003866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladwin, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.