Individual provider Active NPI

David Liao Jr.

  • Physical Therapy Assistant
  • Detroit, MI
National Provider Identifier
1700402559
Registry record updated Jun 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4802953 Issued in MI
Practice address
2102 Orleans St
Detroit, MI 48207-2769
Phone
(248) 577-2632
NPI assigned
Jun 17, 2020
Last updated
Jun 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5502005126 MI
Physical Therapy Assistant 225200000X 4802953 MI Primary

Addresses

Primary practice location

2102 Orleans St
Detroit, MI 48207-2769

Mailing address

27116 Townley St
Madison Heights, MI 48071-3379
Phone (734) 679-5351

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
5502005126MIMDPhysical Medicine & Rehabilitation Physician
4802953MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593302400000",
    "number": "1700402559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27116 TOWNLEY ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713379",
            "telephone_number": "734-679-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 ORLEANS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072769",
            "telephone_number": "248-577-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAO",
        "first_name": "DAVID",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5502005126",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "4802953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; 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.