1992979827 NPI number — MS. JOANN GARY ALLINGTON P.T.

Table of content: MS. JOANN GARY ALLINGTON P.T. (NPI 1992979827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992979827 NPI number — MS. JOANN GARY ALLINGTON P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLINGTON
Provider First Name:
JOANN
Provider Middle Name:
GARY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARY
Provider Other First Name:
JOANN
Provider Other Middle Name:
PETERSON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992979827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33900 HARPER AVE STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON TWP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48035-4258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 SAGAMORE PKWY W STE 2W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST LAFAYETTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47906-1459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-250-9660
Provider Business Practice Location Address Fax Number:
765-250-9661
Provider Enumeration Date:
04/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  05006593A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200650720 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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