Active NPI
Michelle K Nomura, MPT
- Orthopedic Physical Therapist
- Fremont, CA
National Provider Identifier
1801951652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT22842
- Practice address
- 39180 Farwell Dr. Suite 101
Fremont, CA 94538 - Phone
- (510) 438-0294
- Fax
- (510) 438-0468
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT22842 | CA | Primary |
Addresses
Primary practice location
39180 Farwell Dr. Suite 101
Fremont, CA 94538
Mailing address
39810 Farwell Dr. Suite 101
Fremont, CA 94538
Phone (510) 438-0294
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT22842 | CA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sport Clinic Inc | Orthopedic | Current | Accepting new patients |
Locations
39180 Farwell Dr
Ste 101
Fremont, CA 94538
Phone (510) 438-0294
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299801600000",
"number": "1801951652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39810 FARWELL DR. SUITE 101",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-438-0294",
"fax_number": "510-438-0468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39180 FARWELL DR. SUITE 101",
"city": "FREMONT",
"state": "CA",
"postal_code": "94538",
"telephone_number": "510-438-0294",
"fax_number": "510-438-0468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOMURA",
"first_name": "MICHELLE",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2011-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT22842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.