Individual provider Active NPI

Michele Warren, PT

  • Specialist
  • Cherry Hill, NJ
National Provider Identifier
1588753396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
40QA00388400 Issued in NJ
Practice address
1301 Springdale Rd
Cherry Hill, NJ 08003-2763
Phone
(856) 424-4444
Fax
(856) 673-2589
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 40QA00388400 NJ Primary
Specialist 174400000X PT001674E PA

Addresses

Primary practice location

1301 Springdale Rd
Cherry Hill, NJ 08003-2763

Mailing address

103 Simi CT
Cherry Hill, NJ 08003-3752

Other identifiers 3

IdentifierTypeStateIssuer
1412556OtherNJUNITEDHEALTHCARE MPIN
147339OtherNJAMERIHEALTH
2230040OtherNJFIRST HEALTH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00388400NJMDSpecialist
PT001674EPAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588753396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SIMI CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SPRINGDALE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032763",
            "telephone_number": "856-424-4444",
            "fax_number": "856-673-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MICHELE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA00388400",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT001674E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE MPIN",
            "identifier": "1412556",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "147339",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2230040",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.