Individual provider Active NPI

Courtney Clancy Pasiak, PT

  • Physical Therapist
  • Mt Pleasant, MI
National Provider Identifier
1992969646
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013928 Issued in MI
Practice address
1106 W High St
Mt Pleasant, MI 48858-2242
Phone
(989) 779-2920
Fax
(989) 772-9424
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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 5501013928 MI Primary

Addresses

Primary practice location

1106 W High St
Mt Pleasant, MI 48858-2242

Mailing address

1106 W High St
Mt Pleasant, MI 48858-2242
Phone (989) 779-2920

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Town Rehab, Inc Physical Therapist PastSince Jan 1, 2003 Accepting new patients

Organizations & group practices 1

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1992969646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 W HIGH ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582242",
            "telephone_number": "989-779-2920",
            "fax_number": "989-772-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 W HIGH ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582242",
            "telephone_number": "989-779-2920",
            "fax_number": "989-772-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASIAK",
        "first_name": "COURTNEY",
        "middle_name": "CLANCY",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.