Active NPI
Ryan Fedore, DPT
- Physical Therapist
- Three Rivers, MI
National Provider Identifier
1952844284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501014610
- Practice address
- 501 S Health Pkwy
Three Rivers, MI 49093-8350 - Phone
- (269) 273-9682
- Fax
- (269) 273-9626
- NPI assigned
- Nov 18, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 5501014610 | MI | Primary |
Addresses
Primary practice location
501 S Health Pkwy
Three Rivers, MI 49093-8350
Mailing address
501 S Health Pkwy
Three Rivers, MI 49093-8350
Phone (269) 273-9682
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501014610 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1952844284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S HEALTH PKWY",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490938350",
"telephone_number": "269-273-9682",
"fax_number": "269-273-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S HEALTH PKWY",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490938350",
"telephone_number": "269-273-9682",
"fax_number": "269-273-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDORE",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-18",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501014610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.