Timothy Todd Axtell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501009565 Issued in MI

Practice address

3051 Kiesel Rd
Bay City, MI 48706-2449

Phone

(989) 778-2839

Fax

(989) 778-2898

NPI assigned

Jun 24, 2006

Last updated

Jul 8, 2020By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Midland Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Midland, MI
  • NPI 1629181920

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1861428328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 WILMINGTON DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426255",
            "telephone_number": "989-778-2839",
            "fax_number": "989-778-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 KIESEL RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062449",
            "telephone_number": "989-778-2839",
            "fax_number": "989-778-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXTELL",
        "first_name": "TIMOTHY",
        "middle_name": "TODD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "650B610090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autism and Neurodiversity Services
• Autism Evolution
• Katie Autry
• Autumn Ridge Gardens
• Autumn Ridge Home Care LLC
• Ayala & Associates Counseling Group, PLLC
• Emilee Ayala, BCBA, LBA
• Kyleigh Lynn Ayala, MA, LPC
• B.a. Hearing, Inc (Bay Area Hearing, Inc.)
• Nita Katherine Babcock, M.D.

• Physical Therapist in Bay City, MI
• Providers in Bay City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.