Individual provider Active NPI

Michael S Hugues, LPTA

  • Physical Therapy Assistant
  • Pocatello, ID
National Provider Identifier
1669758439
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-377 Issued in ID
Practice address
1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912
Phone
(208) 233-2248
Fax
(208) 233-0219
NPI assigned
Oct 25, 2011
Last updated
Oct 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-377 ID Primary

Addresses

Primary practice location

1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912

Mailing address

1800 Flandro Dr
Suite 190
Pocatello, ID 83202-4912
Phone (208) 233-2248

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
PTA-377IDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1669758439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR",
            "address_2": "SUITE 190",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024912",
            "telephone_number": "208-233-2248",
            "fax_number": "208-233-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR",
            "address_2": "SUITE 190",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024912",
            "telephone_number": "208-233-2248",
            "fax_number": "208-233-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGUES",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.