Michigan Spine & Orthopedic Rehab Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5501003609 Issued in MI

Legal business name

MICHIGAN SPINE & ORTHOPEDIC REHAB INC

Practice address

4918 W Clark Rd
Ste 102
Ypsilanti, MI 48197-1142

Phone

(734) 572-9800

Fax

(734) 572-0762

NPI assigned

Aug 2, 2005

Last updated

May 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara J Johnson, MS, PT

Title

President

Phone

(734) 572-9800

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1003817909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 W CLARK RD",
            "address_2": "STE 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971142",
            "telephone_number": "734-572-9800",
            "fax_number": "734-572-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4918 W CLARK RD",
            "address_2": "STE 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971142",
            "telephone_number": "734-572-9800",
            "fax_number": "734-572-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPINE & ORTHOPEDIC REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-572-9800",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501003609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "366180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "100136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5691619",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30382",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "RT810006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Orthopedic Services LLC
• Michigan Otolaryngolgy Surgery
• Michigan Otolaryngology Surgery
• Michigan Otolaryngology Surgery Associates
• Michigan Pain Institute, PLLC
• Microcosm, LLC
• Emily Middlebrook
• Midwest Journeys LLC
• Midwest Management Company, LLC (Warrenton Weightloss Center)
• Midwest Medflight

• Physical Therapy Clinic/Center in Ypsilanti, MI
• Providers in Ypsilanti, 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 May 12, 2010; 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.