Individual provider Active NPI

Liezel Radey

  • Physical Therapist
  • Midland, MI
National Provider Identifier
1598258444
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007227 Issued in MI
Practice address
3007 N Saginaw Rd
Midland, MI 48640-4555
Phone
(989) 562-5002
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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 5501007227 MI Primary

Addresses

Primary practice location

3007 N Saginaw Rd
Midland, MI 48640-4555

Mailing address

1274 W Superior St
Alma, MI 48801-2134

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
5501007227MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1598258444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1274 W SUPERIOR ST",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488012134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404555",
            "telephone_number": "989-562-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEY",
        "first_name": "LIEZEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.