Individual provider Active NPI

James Fradette, M.P.T.

  • Physical Therapist
  • Charlotte, MI
National Provider Identifier
1902159478
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011061 Issued in MI
Practice address
616 Meijer Dr
Suite 106
Charlotte, MI 48813-8376
Phone
(517) 543-3459
Fax
(517) 543-3646
NPI assigned
Oct 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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 5501011061 MI Primary

Addresses

Primary practice location

616 Meijer Dr
Suite 106
Charlotte, MI 48813-8376

Mailing address

PO Box 558
Dewitt, MI 48820-0558

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
5501011061MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Rehab Associates Past Accepting new patients
Capitol Area Physical Therapy Associates, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1902159478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 558",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488200558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MEIJER DR",
            "address_2": "SUITE 106",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488138376",
            "telephone_number": "517-543-3459",
            "fax_number": "517-543-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRADETTE",
        "first_name": "JAMES",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.