Mickey L Updegraff, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36817 Issued in FL

Practice address

503 Bridge St
New Cumberland, PA 17070-1972

Phone

(717) 774-8210

NPI assigned

Jan 23, 2009

Last updated

Jun 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mickey.updegraff.2@14940.direct.athenahealth.com

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.

• The Villages Rehabilitation Services LLC

  dba Lake Centre for Rehabilitation at the Villages

  • Rehabilitation Clinic/Center
  • Lady Lake, FL
  • NPI 1407922735
  NPD (past)

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1831337245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 GROVE MNR",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593533",
            "telephone_number": "717-448-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 BRIDGE ST",
            "city": "NEW CUMBERLAND",
            "state": "PA",
            "postal_code": "170701972",
            "telephone_number": "717-774-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPDEGRAFF",
        "first_name": "MICKEY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2021-06-07",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT007394L",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028252-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally J Tice, PH.D.
• Treichler Physical Therapy, LLC
• Treichler Sports & Family Chiropractic, Inc.
• Michael Everet Treichler, DC, ATC, EXPH
• Sara Elizabeth Trimmer, PHARMD
• Linda Valencik
• Donald J Vanboskirk, D.C.
• Arjun Ruchik Vyas, DO
• Stephanie L Weaver, CMT, NCBTMB
• Nicole Werner

• Physical Therapist in New Cumberland, PA
• Providers in New Cumberland, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.