Active NPI
Tereasa Renee Calleja, PT
- Physical Therapist
- Davison, MI
National Provider Identifier
1578034864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501003189
- Practice address
- 1515 Cal Dr
Davison, MI 48423-9016 - Phone
- (810) 496-8888
- NPI assigned
- Dec 11, 2018
- Last updated
- Dec 11, 2018
- 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 Therapist | 225100000X | 5501003189 | MI | Primary |
Addresses
Primary practice location
1515 Cal Dr
Davison, MI 48423-9016
Mailing address
8199 E Lippincott Blvd
Davison, MI 48423-8359
Phone (586) 996-1012
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 |
|---|---|---|---|
| 5501003189 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1578034864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8199 E LIPPINCOTT BLVD",
"city": "DAVISON",
"state": "MI",
"postal_code": "484238359",
"telephone_number": "586-996-1012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 CAL DR",
"city": "DAVISON",
"state": "MI",
"postal_code": "484239016",
"telephone_number": "810-496-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLEJA",
"first_name": "TEREASA",
"middle_name": "RENEE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-11",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501003189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.