Active NPI
Adislen Costa, PT, DPT
- Physical Therapist
- Wyoming, MI
National Provider Identifier
1831647684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501017889
- Practice address
- 2786 56TH St SW
Wyoming, MI 49418-8708 - Phone
- (616) 260-9641
- NPI assigned
- Sep 21, 2016
- 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 | 5501017889 | MI | Primary |
Addresses
Primary practice location
2786 56TH St SW
Wyoming, MI 49418-8708
Mailing address
7667 Coconut Dr
Jenison, MI 49428-9170
Phone (616) 260-9641
Other names 1
- Adislen Perez-Varela
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1831647684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7667 COCONUT DR",
"city": "JENISON",
"state": "MI",
"postal_code": "494289170",
"telephone_number": "616-260-9641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2786 56TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "494188708",
"telephone_number": "616-260-9641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "ADISLEN",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ADISLEN",
"last_name": "PEREZ-VARELA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.