Active NPI
Kids in Motion
- Respite Care
- Highland, MI
National Provider Identifier
1063802114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- License
- 5502004079
- Legal business name
- KIDS IN MOTION
- Practice address
- 2636 S. Milford Road
Highland, MI 48357 - Phone
- (248) 684-9610
- NPI assigned
- Jan 28, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Hydorn
- Title
- PT
- Phone
- (248) 684-9610
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | 5502004079 | MI | Primary |
Addresses
Primary practice location
2636 S. Milford Road
Highland, MI 48357
Mailing address
6281 Middle Lake Road
Clarkston, MI 48346
Phone (248) 202-7510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | MI | TAXONOMY |
National Provider Directory
National Provider DirectoryLocations
2636 S Milford Rd
Highland, MI 48357
Phone (248) 684-9610
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Physical Therapist
- Highland, MI
- NPI 1700090628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1422403200000",
"number": "1063802114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6281 MIDDLE LAKE ROAD",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "48346",
"telephone_number": "248-202-7510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2636 S. MILFORD ROAD",
"city": "HIGHLAND",
"state": "MI",
"postal_code": "48357",
"telephone_number": "248-684-9610"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIDS IN MOTION",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-28",
"last_updated": "2015-01-28",
"status": "A",
"authorized_official_last_name": "HYDORN",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "PT",
"authorized_official_telephone_number": "248-684-9610"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "MI",
"license": "5502004079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAXONOMY",
"identifier": "22",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Highland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.