Individual provider Active NPI

Michelle Short Lollar, PT

  • Physical Therapist
  • Mobile, AL
National Provider Identifier
1932315587
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1596 Issued in AL
Practice address
1515 University Blvd S
Mobile, AL 36609-2958
Phone
(251) 343-9600
Fax
(251) 380-3328
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1596 AL Primary

Addresses

Primary practice location

1515 University Blvd S
Mobile, AL 36609-2958

Mailing address

11884 Padgett Switch Rd
Irvington, AL 36544-4106
Phone (251) 343-9600

Other identifiers 1

IdentifierTypeStateIssuer
1596OtherALSTATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
1596ALMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932315587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11884 PADGETT SWITCH RD",
            "city": "IRVINGTON",
            "state": "AL",
            "postal_code": "365444106",
            "telephone_number": "251-343-9600",
            "fax_number": "251-380-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 UNIVERSITY BLVD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366092958",
            "telephone_number": "251-343-9600",
            "fax_number": "251-380-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLLAR",
        "first_name": "MICHELLE",
        "middle_name": "SHORT",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "1596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1596",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.