Individual provider Active NPI

Debra Reish-Mitchell

  • Physical Therapist
  • Ypsilanti, MI
National Provider Identifier
1083005383
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006141 Issued in MI
Practice address
3145 W Clark Rd
Ypsilanti, MI 48197-1120
Phone
(734) 528-9760
Fax
(734) 528-9761
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501006141 MI Primary

Addresses

Primary practice location

3145 W Clark Rd
Ypsilanti, MI 48197-1120

Mailing address

3145 W Clark Rd
Ypsilanti, MI 48197-1120
Phone (734) 528-9760

Other names 1

  • Debra L Reish Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150505000490 MI Practitioner - Physical Therapist in Private Practice 3577882026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Max Well Therapy LLCGroup PAC ID 7113825670, 6 clinicians

Practice addresses (Care Compare)

1289 S Linden Rd
Suite a
Flint, MI 48532-3499
Phone (810) 230-9750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501006141MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Max Well Therapy LLC Physical Therapist CurrentSince Jun 26, 2024 Accepting new patients
Max Well Therapy L.L.C. Physical Therapist CurrentSince Jun 26, 2024 Accepting new patients
Spine and Extremity Institute of South Lyon, L.L.C. Physical Therapist CurrentSince Nov 27, 2017 Accepting new patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist PastSince Nov 27, 2017 Accepting new patients
Kinetic Rehabilitation Inc. Past Accepting new patients

Locations

1289 S Linden Rd
Ste A
Flint, MI 48532
Phone (810) 230-9750

8263 S Saginaw St
Ste 5
Grand Blanc, MI 48439
Phone (810) 230-9750

22180 Pontiac Trl
Ste E
South Lyon, MI 48178
Phone (248) 446-0155

22180 Pontiac Trl
South Lyon, MI 48178
Phone (248) 446-0155

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1083005383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 W CLARK RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971120",
            "telephone_number": "734-528-9760",
            "fax_number": "734-528-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 W CLARK RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971120",
            "telephone_number": "734-528-9760",
            "fax_number": "734-528-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISH-MITCHELL",
        "first_name": "DEBRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "REISH",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.