Prescott Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PRESCOTT PHYSICAL THERAPY, LLC

Practice address

311 E Harrison St
Prescott, MI 48756-5135

Phone

(989) 873-2540

Fax

(989) 873-2542

NPI assigned

Dec 27, 2021

Organization subpart

No

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

Authorized official

Name

Sharon Isaac

Title

Office Manager

Phone

(989) 873-2540

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Ann Cummings, OTR

  • Occupational Therapist
  • West Branch, MI
  • NPI 1477881589
  Medicare reassignment Care Compare group NPD
• Vijay Kumar, PT,PHD

  • Physical Therapist
  • West Branch, MI
  • NPI 1730133117
  Medicare reassignment Care Compare group NPD
• Heide Morgan, PT

  • Physical Therapist
  • West Branch, MI
  • NPI 1528465648
  Medicare reassignment Care Compare group NPD
• Christopher Sakala, P.T.

  • Physical Therapist
  • Mt Pleasant, MI
  • NPI 1043387038
  Medicare reassignment NPD

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1003576448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "PRESCOTT",
            "state": "MI",
            "postal_code": "487560215",
            "telephone_number": "989-873-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E HARRISON ST",
            "city": "PRESCOTT",
            "state": "MI",
            "postal_code": "487565135",
            "telephone_number": "989-873-2540",
            "fax_number": "989-873-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "ISAAC",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-873-2540"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mad World Wellness PLLC
• Antonio F Mendiola Jr., M.D.
• Annemarie Catherine Poleck, D.O.
• Prescott Clinic P.C.
• Prescott Clinic P.C.
• Roos Pharmacy North, Inc.
• Skidway Pharmacy LLC
• Sterling Area Health Center
• Gabriel Wayne Wallace
• Jimmie S Ward Sr., PA-C

• Physical Therapy Clinic/Center in Prescott, MI
• Providers in Prescott, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.