Individual provider Active NPI

Shivani Deshmukh, PT

  • Physical Therapist
  • Jackson, MI
National Provider Identifier
1588129175
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018921 Issued in MI
Practice address
524 Lansing Ave
Jackson, MI 49201-2804
Phone
(517) 782-2173
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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 5501018921 MI Primary

Addresses

Primary practice location

524 Lansing Ave
Jackson, MI 49201-2804

Mailing address

524 Lansing Ave
Jackson, MI 49201-2804
Phone (517) 782-2173

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
5501018921MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1588129175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012804",
            "telephone_number": "517-782-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012804",
            "telephone_number": "517-782-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHMUKH",
        "first_name": "SHIVANI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.