Active NPI
Vinoth Periyasamy, MPT
- Physical Therapist
- Sterling Heights, MI
National Provider Identifier
1861721656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501013741
- Practice address
- 2445 Tavistock CT
Sterling Heights, MI 48310-7109 - Phone
- (248) 764-0700
- NPI assigned
- Dec 8, 2009
- Last updated
- Dec 8, 2009
- Sex
- Male
- 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 | 5501013741 | MI | Primary |
Addresses
Primary practice location
2445 Tavistock CT
Sterling Heights, MI 48310-7109
Mailing address
2445 Tavistock CT
Sterling Heights, MI 48310-7109
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08111978 | Medicaid | MI |
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": "1260230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260230400000",
"number": "1861721656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 TAVISTOCK CT",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483107109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2445 TAVISTOCK CT",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483107109",
"telephone_number": "248-764-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERIYASAMY",
"first_name": "VINOTH",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-08",
"last_updated": "2009-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501013741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08111978",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
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- Barbara Jean Perry, OTRL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.