Individual provider Active NPI

Priyanka Villanassery

  • Physical Therapist
  • Shelby Township, MI
National Provider Identifier
1811465545
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018960 Issued in MI
Practice address
15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone
(586) 286-9644
Fax
(586) 286-9647
NPI assigned
Nov 12, 2018
Last updated
Nov 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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 5501018960 MI Primary

Addresses

Primary practice location

15023 21 Mile Rd
Shelby Township, MI 48315-5024

Mailing address

15023 21 Mile Rd
Shelby Township, MI 48315-5024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001226 NV Practitioner - Physical Therapist in Private Practice 8325382237 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018960MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Slptele LLC Physical Therapist CurrentSince May 8, 2025 Accepting new patients
Theraplay Solutions LLC Physical Therapist Past Accepting new patients
Quality Care Rehabilitation Professionals PastSince Nov 14, 2018 Accepting new patients

Locations

6320 Canoga Ave
Fl 15
Woodland Hls, CA 91367
Phone (818) 588-4003

601 N Pecos Rd
Las Vegas, NV 89101
Phone (702) 455-2202

1306 E Calvada Blvd
Pahrump, NV 89048
Phone (702) 339-8770

Organizations & group practices 3

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1811465545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANASSERY",
        "first_name": "PRIYANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.