Individual provider Active NPI

Mriga Mukul Bhatia

  • Physical Therapist
  • Jackson, MI
National Provider Identifier
1679075964
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017823 Issued in MI
Practice address
100 E Michigan Ave
Jackson, MI 49201-1498
Phone
(517) 205-7252
NPI assigned
Mar 2, 2018
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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 5501017823 MI Primary

Addresses

Primary practice location

100 E Michigan Ave
Jackson, MI 49201-1498

Mailing address

100 E Michigan Ave
Jackson, MI 49201-1498
Phone (517) 205-7252

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
5501017823MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1679075964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011498",
            "telephone_number": "517-205-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011498",
            "telephone_number": "517-205-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "MRIGA",
        "middle_name": "MUKUL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.