Individual provider Active NPI

Michael R. Land, D.P.T.

  • Physical Therapist
  • Lillian, AL
National Provider Identifier
1770627440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH3908 Issued in AL
Practice address
12831 6TH St
Suite C&D
Lillian, AL 36549-4166
Phone
(251) 962-2149
Fax
(251) 961-3815
NPI assigned
Feb 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PTH3908 AL Primary

Addresses

Primary practice location

12831 6TH St
Suite C&D
Lillian, AL 36549-4166

Mailing address

12831 6TH St
Suite C&D
Lillian, AL 36549-4166
Phone (251) 962-2149

Other identifiers 1

IdentifierTypeStateIssuer
51511982OtherALBC BS AL

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

State licenses

LicenseStateTypeSpecialty
PTH3908ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist Past Accepting new patients
Physical Therapy Specialists, Inc. Physical Therapist PastSince Nov 1, 2002 Accepting new patients
Star Sports Medicine PA Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770627440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12831 6TH ST",
            "address_2": "SUITE C&D",
            "city": "LILLIAN",
            "state": "AL",
            "postal_code": "365494166",
            "telephone_number": "251-962-2149",
            "fax_number": "251-961-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12831 6TH ST",
            "address_2": "SUITE C&D",
            "city": "LILLIAN",
            "state": "AL",
            "postal_code": "365494166",
            "telephone_number": "251-962-2149",
            "fax_number": "251-961-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS AL",
            "identifier": "51511982",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillian, AL

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.

Verify at the official NPI Registry.