Wright Avenue Rehab, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WRIGHT AVENUE REHAB, PLLC

Doing business as

Wright Avenue Rehab

Practice address

331 E Wright Ave
Shepherd, MI 48883-8065

Phone

(989) 567-1300

Fax

(989) 567-1301

NPI assigned

Aug 25, 2020

Last updated

Jan 15, 2021By 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

Dr. Matthew Dwayne Blick, DPTNPI 1750809455

Title

Owner

Phone

(989) 567-1300

Specialties & licenses 1

Addresses

Other names 1

• Wright Avenue Rehab Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Dwayne Blick, PHYSICAL THERAPIST

  • Physical Therapist
  • Shepherd, MI
  • NPI 1750809455
  NPD Authorized official

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1013520576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488838065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488838065",
            "telephone_number": "989-567-1300",
            "fax_number": "989-567-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRIGHT AVENUE REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "BLICK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-567-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wright Avenue Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wright Avenue Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shepherd Clinic PLC
• Sweetwater Medical Center
• Sweetwater Urgent Care
• Joanne Wallace, RN
• Emily Willoughby
• Angie Area Yuncker
• Janet Ziesemer Malusi

• Physical Therapist in Shepherd, MI
• Providers in Shepherd, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.