Active NPI
Primal M Patel, RPT
- Physical Therapist
- Grand Blanc, MI
National Provider Identifier
1780914200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501013739
- Practice address
- 8481 Holly Rd
#103
Grand Blanc, MI 48439-1812 - Phone
- (810) 603-1111
- NPI assigned
- Jan 5, 2010
- 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 | 5501013739 | MI | Primary |
Addresses
Primary practice location
8481 Holly Rd
#103
Grand Blanc, MI 48439-1812
Mailing address
1349 Winding Ridge Dr Apt 1B
Grand Blanc, MI 48439-7571
Phone (810) 941-7548
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 |
|---|---|---|---|
| 5501013739 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374192000000",
"number": "1780914200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1349 WINDING RIDGE DR APT 1B",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484397571",
"telephone_number": "810-941-7548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8481 HOLLY RD",
"address_2": "#103",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484391812",
"telephone_number": "810-603-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "PRIMAL",
"middle_name": "M",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-05",
"last_updated": "2013-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501013739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.