Healthcare Provider Details
I. General information
NPI: 1659367050
Provider Name (Legal Business Name): MICHELLE L ALBRECHT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 09/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1720 S CLIFF AVE
SIOUX FALLS SD
57105-2129
US
IV. Provider business mailing address
1720 S CLIFF AVE
SIOUX FALLS SD
57105-2129
US
V. Phone/Fax
- Phone: 605-334-5630
- Fax: 605-332-5327
- Phone: 605-334-5630
- Fax: 605-332-5327
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 1024 |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 6453 |
| License Number State | MN |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1024 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | DAKOTACARE |
| # 2 | |
| Identifier | 26F64BA |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS BLUE SHIELD MN |
| # 3 | |
| Identifier | 64-01179 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | MEDICA |
| # 4 | |
| Identifier | 4994833 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS BLUE SHIELD SD |
| # 5 | |
| Identifier | 869314 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | ARAZ |
| # 6 | |
| Identifier | 64-00662 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | MEDICA |
| # 7 | |
| Identifier | 5832155 |
| Identifier Type | MEDICAID |
| Identifier State | SD |
| Identifier Issuer | |
| # 8 | |
| Identifier | 5832150 |
| Identifier Type | MEDICAID |
| Identifier State | SD |
| Identifier Issuer | |
| # 9 | |
| Identifier | 4997711 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS BLUE SHIELD SD |
| # 10 | |
| Identifier | 64-05324 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | MEDICA |
| # 11 | |
| Identifier | 26F65BA |
| Identifier Type | OTHER |
| Identifier State | MN |
| Identifier Issuer | BLUE CROSS BLUE SHIELD MN |
| # 12 | |
| Identifier | 31676 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | SIOUX VALLEY HEALTH PLANS |
| # 13 | |
| Identifier | 4997712 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS BLUE SHIELD SD |
| # 14 | |
| Identifier | 5832153 |
| Identifier Type | MEDICAID |
| Identifier State | SD |
| Identifier Issuer | |
| # 15 | |
| Identifier | 4997710 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | BLUE CROSS BLUE SHIELD SD |
| # 16 | |
| Identifier | 5832152 |
| Identifier Type | MEDICAID |
| Identifier State | SD |
| Identifier Issuer | |
| # 17 | |
| Identifier | 64-04207 |
| Identifier Type | OTHER |
| Identifier State | SD |
| Identifier Issuer | MEDICA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
