Active Physical Therapy and Rehab Services Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

N/A

Legal business name

ACTIVE PHYSICAL THERAPY AND REHAB SERVICES INC.

Practice address

718 Huron Ave
Port Huron, MI 48060-3704

Phone

(810) 966-8500

Fax

(810) 966-8600

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Chamundeeswari Muthuvinayagam, PHYSICALTHERAPIST

Title

Owner/Administrator

Phone

(810) 966-8500

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 236782

Legal name

Active Physical Therapy & Rehab Services, Inc.

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Mar 30, 2001

Last certification

Jan 20, 2022

Ownership / control type

Proprietary

Most recent change of ownership

May 3, 2006

Facility address

718 Huron Ave
Port Huron, MI 48060

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muthuvinayagam Murugan, RPT

  • Physical Therapist
  • Port Huron, MI
  • NPI 1194845792
  NPD
• Chamu Muthuvinayagam, RPT

  • Physical Therapist
  • Port Huron, MI
  • NPI 1770706616
  NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1053364679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603704",
            "telephone_number": "810-966-8500",
            "fax_number": "810-966-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603704",
            "telephone_number": "810-966-8500",
            "fax_number": "810-966-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE PHYSICAL THERAPY AND REHAB SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "MUTHUVINAYAGAM",
        "authorized_official_first_name": "CHAMUNDEESWARI",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "810-966-8500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHYSICALTHERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE NETWORK",
            "identifier": "1053364679",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30045",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5183763",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30901",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Rehabilitation Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.