Proven Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROVEN PHYSICAL THERAPY LLC

Practice address

145 E Cady St
Northville, MI 48167-1606

Phone

(248) 773-7540

Fax

(248) 907-1117

NPI assigned

Dec 1, 2021

Last updated

Feb 13, 2023By 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. Craig Serra, PT,DPT,OCS,FAAOMPTNPI 1023331527

Title

Owner

Phone

(586) 322-1940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 5

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.

• Craig J Serra, DPT, OCS, FAAOMPT

  • Physical Therapist
  • Northville, MI
  • NPI 1023331527
  Medicare reassignment Care Compare group NPD Authorized official
• Denise Patterson, P.T.

  • Physical Therapist
  • Northville, MI
  • NPI 1730590670
  Medicare reassignment Care Compare group NPD
• Diane L Quigley, MPT

  • Physical Therapist
  • Ann Arbor, MI
  • NPI 1215006895
  Medicare reassignment Care Compare group NPD
• Susan E Taube, PT

  • Physical Therapist
  • Northville, MI
  • NPI 1659499630
  Medicare reassignment Care Compare group NPD
• John Daniels, PT, DPT

  • Physical Therapist
  • Northville, MI
  • NPI 1265386577
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1053079509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E CADY ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671606",
            "telephone_number": "248-773-7540",
            "fax_number": "248-907-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E CADY ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671606",
            "telephone_number": "248-773-7540",
            "fax_number": "248-907-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVEN PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "SERRA",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-322-1940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT,DPT,OCS,FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Pouliot, DPT
• Jayne Poyner-Whitaker, LMT
• Precision Performance Collective
• Preservation Dental
• Professional Consultation Services (PCS-Counseling)
• Psychotherapy & Counseling Services, Inc.
• Patricia Kozlowski Ptak, M.A. LPC
• Megan Michell Pummell, LAT, ATC
• Mandra Quassis
• Quest Diagnostics Incorporated

• Physical Therapy Clinic/Center in Northville, MI
• Providers in Northville, 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 Feb 13, 2023; 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.