Individual provider Active NPI

Karen Metcalf, PTA

  • Physical Therapy Assistant
  • Clinton Township, MI
National Provider Identifier
1760933501
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502004954 Issued in MI
Practice address
33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258
Phone
(586) 416-9100
Fax
(586) 416-9103
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502004954 MI Primary

Addresses

Primary practice location

33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258

Mailing address

33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258
Phone (586) 416-9100

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
5502004954MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1760933501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-416-9100",
            "fax_number": "586-416-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-416-9100",
            "fax_number": "586-416-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "KAREN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.