Lynne M Nidek, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 009632 Issued in OH

Practice address

100 Powell Dr
Dundee, MI 48131-8644

Phone

(419) 276-2976

NPI assigned

Feb 9, 2012

Last updated

Jan 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1689947467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 KILBURN RD",
            "city": "BERKEY",
            "state": "OH",
            "postal_code": "435049731",
            "telephone_number": "419-787-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POWELL DR",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481318644",
            "telephone_number": "419-276-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3424 Kilburn Rd",
            "address_purpose": "LOCATION",
            "city": "Berkey",
            "state": "OH",
            "postal_code": "435049731",
            "country_code": "US",
            "telephone_number": "419-787-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIDEK",
        "first_name": "LYNNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015682",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 009632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Dundee, MI
• Providers in Dundee, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.