NPIMap

Organization Active NPI

At Home Physical Therapy

  • Physical Therapist
  • Dryden, MI
National Provider Identifier
1003833716
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010803 Issued in MI
Legal business name
AT HOME PHYSICAL THERAPY
Practice address
5654 Belle Ridge CT
Dryden, MI 48428-9240
Phone
(810) 796-9102
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Laura A Ellis, PT
Title
Owner
Phone
(810) 796-9102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5501010803 MI Primary

Addresses

Primary practice location

5654 Belle Ridge CT
Dryden, MI 48428-9240

Mailing address

5654 Belle Ridge CT
Dryden, MI 48428-9240

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003833716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5654 BELLE RIDGE CT",
            "city": "DRYDEN",
            "state": "MI",
            "postal_code": "484289240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5654 BELLE RIDGE CT",
            "city": "DRYDEN",
            "state": "MI",
            "postal_code": "484289240",
            "telephone_number": "810-796-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-796-9102",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dryden, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.