Individual provider Active NPI

Michael R Engle, RKT

  • Kinesiotherapist
  • Lake City, FL
National Provider Identifier
1619920840
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
KinesiotherapistTaxonomy code 226300000X
License
1378 Issued in NU
Practice address
619 S Marion Ave
(117)
Lake City, FL 32025-5808
Phone
(386) 755-3016
NPI assigned
May 18, 2006
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Kinesiotherapist 226300000X 1378 NU Primary

Addresses

Primary practice location

619 S Marion Ave
(117)
Lake City, FL 32025-5808

Mailing address

248 SE Fawn GLN
Lake City, FL 32025-1778
Phone (386) 755-3016

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1619920840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 SE FAWN GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251778",
            "telephone_number": "386-755-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "address_2": "(117)",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RKT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "NU",
            "license": "1378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.