Active NPI
Alexis Ann Hegstrom
- Physical Therapy Assistant
- Crystal Falls, MI
National Provider Identifier
1780148270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2887-19
- Practice address
- 306 N 3Rd St
Crystal Falls, MI 49920-1200 - Phone
- (906) 284-2801
- NPI assigned
- Jan 29, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2887-19 | WI | Primary |
| Physical Therapy Assistant | 225200000X | 5502005720 | MI |
Addresses
Primary practice location
306 N 3Rd St
Crystal Falls, MI 49920-1200
Mailing address
306 N 3Rd St
Crystal Falls, MI 49920-1200
Phone (906) 284-2801
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 |
|---|---|---|---|
| 5502005720 | MI | MD | Physical Therapy Assistant |
| 2887-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1780148270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 N 3RD ST",
"city": "CRYSTAL FALLS",
"state": "MI",
"postal_code": "499201200",
"telephone_number": "906-284-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 N 3RD ST",
"city": "CRYSTAL FALLS",
"state": "MI",
"postal_code": "499201200",
"telephone_number": "906-284-2801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEGSTROM",
"first_name": "ALEXIS",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-29",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2887-19",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502005720",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Falls, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.