Mitchell David Anderson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501302632 Issued in MI

Practice address

1345 E Parkdale Ave
Manistee, MI 49660-9318

Phone

(231) 398-1166

NPI assigned

Sep 14, 2022

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lighthouse, Inc.

  • Rehabilitation Clinic/Center
  • Caro, MI
  • NPI 1770661092
  NPD (past)

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1962124107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609318",
            "telephone_number": "231-398-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609318",
            "telephone_number": "231-398-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MITCHELL",
        "middle_name": "DAVID",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Alpers
• Ambersource, PLLC
• Amy L Beeman DO PLLC
• Kimberly S. Anderson, D.C.
• Melda Louise Anderson, RN
• Paul D Anderson, PHARMACIST
• Andrew S Riemer DO PC
• Paul Joseph Antal, M.D.
• Tina Argue
• Taylor Babashka, M.S. CCC-SLP

• Physical Therapist in Manistee, MI
• Providers in Manistee, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.