Active NPI
Jeraka Lyndsy Michael, DPT
- Physical Therapist
- Newton, KS
National Provider Identifier
1649799545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-04626
- Practice address
- 600 Medical Center Dr
Newton, KS 67114-8780 - Phone
- (316) 283-2700
- NPI assigned
- Sep 12, 2017
- Last updated
- Sep 12, 2017
- 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 | 11-04626 | KS | Primary |
Addresses
Primary practice location
600 Medical Center Dr
Newton, KS 67114-8780
Mailing address
445 E Kodiak CT
Kechi, KS 67067-7609
Phone (316) 258-6980
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11-04626 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1649799545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 E KODIAK CT",
"city": "KECHI",
"state": "KS",
"postal_code": "670677609",
"telephone_number": "316-258-6980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MEDICAL CENTER DR",
"city": "NEWTON",
"state": "KS",
"postal_code": "671148780",
"telephone_number": "316-283-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "JERAKA",
"middle_name": "LYNDSY",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-12",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-04626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.