Individual provider Active NPI

Debra I Cronin, LMT

  • Massage Therapist
  • Waterford, MI
National Provider Identifier
1891204186
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
563175 Issued in MI
Practice address
6650 Highland Rd Ste 119
Waterford, MI 48327-1662
Phone
(248) 618-3050
Fax
(248) 618-3050
NPI assigned
Sep 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 563175 MI Primary

Addresses

Primary practice location

6650 Highland Rd Ste 119
Waterford, MI 48327-1662

Mailing address

6650 Highland Rd Ste 119
Waterford, MI 48327-1662
Phone (248) 618-3050

Other practice location 1

1265 W Huron St Ste 101
Waterford, MI 48328-3677
Phone (248) 977-4594

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
563175MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Physical Therapy Inc Single Specialty CurrentSince Jul 24, 2022 Accepting new patients
Advanced Physical Therapy Center, Inc PastSince Jul 24, 2022 Accepting new patients

Locations

1265 W Huron St
Ste 101
Waterford, MI 48328
Phone (248) 738-7017

6650 Highland Rd
Ste 119
Waterford, MI 48327
Phone (248) 618-3050

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891204186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 HIGHLAND RD STE 119",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271662",
            "telephone_number": "248-618-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 HIGHLAND RD STE 119",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271662",
            "telephone_number": "248-618-3050",
            "fax_number": "248-618-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 W Huron St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483283677",
            "country_code": "US",
            "telephone_number": "248-977-4594",
            "fax_number": "248-977-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "DEBRA",
        "middle_name": "I",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "563175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.