Individual provider Active NPI

Mark Botterill

  • Physical Therapist
  • Rochester Hills, MI
National Provider Identifier
1831690171
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007798 Issued in MI
Practice address
6700 N Rochester Rd
Rochester Hills, MI 48306-4362
Phone
(248) 650-1515
NPI assigned
Feb 22, 2018
Sex
Male
Sole proprietor
No

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

LicenseStateTypeSpecialty
5501007798MIMDPhysical Therapist

NPPES NPI Registry

Updated by the provider on Feb 22, 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 5501007798 MI Primary

Addresses

Primary practice location

6700 N Rochester Rd
Rochester Hills, MI 48306-4362

Mailing address

9384 Maple LN
Clarkston, MI 48348-1552

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1831690171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9384 MAPLE LN",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064362",
            "telephone_number": "248-650-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTERILL",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.