NPIMap

Organization Active NPI

Thunder Bay Therapy & Sports Medicine

  • Occupational Medicine Clinic/Center
  • Alpena, MI
National Provider Identifier
1003203605
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
5201009050 Issued in MI
Legal business name
THUNDER BAY THERAPY & SPORTS MEDICINE
Practice address
348 Long Rapids PLZ
Alpena, MI 49707-1374
Phone
(989) 358-8086
Fax
(989) 354-2253
NPI assigned
Apr 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Miss Kristine Ernst, OTRL
Title
Occupational Therapist
Phone
(313) 282-9304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X 5201009050 MI Primary

Addresses

Primary practice location

348 Long Rapids PLZ
Alpena, MI 49707-1374

Mailing address

6511 Osage Ave
Allen Park, MI 48101-2371
Phone (313) 282-9304

National Provider Directory

National Provider Directory
Tax ID family
Thunder Bay Fyzical Therapy and Balance Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1003203605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 OSAGE AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012371",
            "telephone_number": "313-282-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 LONG RAPIDS PLZ",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071374",
            "telephone_number": "989-358-8086",
            "fax_number": "989-354-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDER BAY THERAPY & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "ERNST",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "313-282-9304",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MI",
            "license": "5201009050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.