Active NPI
Nikki Davoodiaria, DPT
- Physical Therapist
- Bingham Farms, MI
National Provider Identifier
1639455710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501013692
- Practice address
- 30100 Telegraph Rd
Suite 177
Bingham Farms, MI 48025-4514 - Phone
- (248) 647-1470
- Fax
- (248) 647-1472
- NPI assigned
- Nov 2, 2011
- 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 | 5501013692 | MI | Primary |
Addresses
Primary practice location
30100 Telegraph Rd
Suite 177
Bingham Farms, MI 48025-4514
Mailing address
30100 Telegraph Rd
Suite 177
Bingham Farms, MI 48025-4514
Phone (248) 647-1470
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40277 | CA | MD | Pharmacist |
| 5501013692 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1639455710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30100 TELEGRAPH RD",
"address_2": "SUITE 177",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "480254514",
"telephone_number": "248-647-1470",
"fax_number": "248-647-1472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30100 TELEGRAPH RD",
"address_2": "SUITE 177",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "480254514",
"telephone_number": "248-647-1470",
"fax_number": "248-647-1472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVOODIARIA",
"first_name": "NIKKI",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501013692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bingham Farms, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.