Active NPI
Jiayi Chen
- Physical Therapist
- Detroit, MI
National Provider Identifier
1962995571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501004924
- Practice address
- 6071 W Outer Dr
Detroit, MI 48235-2624 - Phone
- (313) 966-3350
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 5501004924 | MI | Primary |
Addresses
Primary practice location
6071 W Outer Dr
Detroit, MI 48235-2624
Mailing address
1778 Hartshorn Ave
Troy, MI 48083-1750
Phone (248) 434-7743
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501004924 | Other | MI | BUREAU OF PROFESSIONAL LICENSING |
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 |
|---|---|---|---|
| 5501004924 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1962995571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1778 HARTSHORN AVE",
"city": "TROY",
"state": "MI",
"postal_code": "480831750",
"telephone_number": "248-434-7743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6071 W OUTER DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352624",
"telephone_number": "313-966-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "JIAYI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501004924",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUREAU OF PROFESSIONAL LICENSING",
"identifier": "5501004924",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.