Individual provider Active NPI

Renee M Przystas, DPT

  • Physical Therapist
  • Spring Lake, MI
National Provider Identifier
1699061655
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015617 Issued in MI
Practice address
18000 Cove Street
Suite 202
Spring Lake, MI 49456-1383
Phone
(616) 847-1280
Fax
(616) 847-1290
NPI assigned
Jun 28, 2011
Last updated
Jul 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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 5501015617 MI Primary

Addresses

Primary practice location

18000 Cove Street
Suite 202
Spring Lake, MI 49456-1383

Mailing address

18000 Cove Street
Suite 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280

Other identifiers 1

IdentifierTypeStateIssuer
5501015617OtherMILICENSE NUMBER

Other names 1

  • Renee Marie Auernhamer Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1699061655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 COVE STREET",
            "address_2": "SUITE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561383",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 COVE STREET",
            "address_2": "SUITE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561383",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRZYSTAS",
        "first_name": "RENEE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "5501015617",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "AUERNHAMER",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.