Michelle Lynn Dominick-Dreyer, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502000597 Issued in MI

Practice address

4431 Bonnymede St
Jackson, MI 49201-8511

Phone

(517) 745-0827

NPI assigned

Feb 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1568094811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 BONNYMEDE ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018511",
            "telephone_number": "517-745-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 BONNYMEDE ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018511",
            "telephone_number": "517-745-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK-DREYER",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502000597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5502000597",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn M Dodge
• Scott Christopher Dodge, RPH
• Brian Doll, DPT
• Devin Dombrowski, LLMSW
• Jean M Dombrowski, RPH
• James L Donahue, M.D.
• Donald C Jones MD PC
• Donald J. Powers, DDS, PC
• Donna M O'Neill M.D. P.C.
• Angela Donnelly

• Physical Therapy Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.