Axalan G Axalan, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501014604 Issued in MI

Practice address

26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309

Phone

(586) 779-7000

NPI assigned

May 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Focus Home Health Care, Inc.

  • Home Health Agency
  • Chicago, IL
  • NPI 1689779910
  NPD

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1780174607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 UNION LAKE RD",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483823582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812309",
            "telephone_number": "586-779-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXALAN",
        "first_name": "AXALAN",
        "middle_name": "G",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501014604",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Associated Retinal Consultants, PC
• Denise Diane Aubry
• Audionet America - St Clair Shores LLC
• Audrey M Sim PLLC
• Conrad Martin Aumann II, PH.D.
• Faten S Ayyoub, MD
• Dana Azzoug
• Jessie Gurleen Babra, M.D.
• Maria Badalamenti-Garippa, D.D.S.
• Nickalene Badalamenti-Kalas, DDS

• Physical Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.