Peggy A Ivan, PT
Individual provider Active NPI Physical Therapist · Freeland, MI
NPI 1013963206 · NPPES record last updated Feb 9, 2012
Key facts
- NPI
- 1013963206
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501004011 (MI)
- Practice address
- 3680 S Orr Rd
Freeland, MI 48623-9111 - Phone
- (989) 695-9282
- Fax
- (989) 695-9283
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Body Mechanics Rehabilitation and Wellness, LLC
Practice addresses (Care Compare)
143 S 1St St
Freeland, MI 48623-2500
Phone (989) 859-5898
3680 S Orr Rd
Freeland, MI 48623-9111
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120808000294 | MI | Practitioner - Physical Therapist in Private Practice | 1850552282 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 406631-00 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Mechanics Rehabilitation & Wellness, LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501004011 | MI | Yes |
| Massage Therapist | 225700000X | 406631-00 | MI |
Addresses
Primary practice location
3680 S Orr Rd
Freeland, MI 48623-9111
Mailing address
3680 S Orr Rd
Freeland, MI 48623-9111
Phone (989) 695-9282
Other providers in Freeland, MI
- Melissa Nicole Horenziak
- Kiara Howe
- Michael Humphrey II
- Ashleigh Hymel
- I Care Vision Center Inc
- J.Robert Vankirk Anesthesia Services, Inc.
- Samantha Marie Jersey
- Emily Brianne Johnson
- Kristin Marie Johnson
- Ashley Jordan
All providers in Freeland, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.