Active NPI
Carolyn M Michalik, P.T.
- Physical Therapist
- Saint Clair Shores, MI
National Provider Identifier
1750420329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501004914
- Practice address
- 20952 E 12 Mile Rd
Ste 110
Saint Clair Shores, MI 48081-3200 - Phone
- (586) 498-3516
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501004914 | MI | Primary |
Addresses
Primary practice location
20952 E 12 Mile Rd
Ste 110
Saint Clair Shores, MI 48081-3200
Mailing address
17545 Adolph
Fraser, MI 48026-1780
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501004914 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750420329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17545 ADOLPH",
"city": "FRASER",
"state": "MI",
"postal_code": "480261780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20952 E 12 MILE RD",
"address_2": "STE 110",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480813200",
"telephone_number": "586-498-3516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHALIK",
"first_name": "CAROLYN",
"middle_name": "M",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501004914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
- Rouba Metwele
- Paul Allan Meyering, D.D.S.
- Thomas Meyering, DDS
- MG Vision Partners PLLC
- Michael G. Taylor,M.D.P.L.C.
- Michigan Center for Traumatic Stress
- Michigan Center for Traumatic Stress
- Michigan Forensic Intervention Services
- Michigan Gastroenterology PLLC
- Michigan Institute of Urology Laboratory
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.