Individual provider Active NPI

Rebecca Lee Ammon, P.T.

  • Physical Therapist
  • Royal Oak, MI
National Provider Identifier
1083732432
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010429 Issued in MI
Practice address
29480 Woodward Ave
Royal Oak, MI 48073-0903
Phone
(248) 541-9121
Fax
(248) 541-8386
NPI assigned
Mar 26, 2007
Last updated
May 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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 5501010429 MI Primary

Addresses

Primary practice location

29480 Woodward Ave
Royal Oak, MI 48073-0903

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120425000757 MI Practitioner - Physical Therapist in Private Practice 0941462683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

24255 W 13 Mile Rd
Suite 100
Bingham Farms, MI 48025-4345
Phone (248) 988-8085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501010429MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Michigan Orthopaedic Surgeons, PLLC Physical Therapist CurrentSince Dec 1, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

1801 W Maumee St
Ste 125
Adrian, MI 49221
Phone (517) 264-6141

2570 Jackson Ave
Ste C
Ann Arbor, MI 48103
Phone (734) 823-7820

17877 W 14 Mile Rd
Beverly Hills, MI 48025
Phone (248) 644-3920

24255 W 13 Mile Rd
Ste 100
Bingham Farms, MI 48025
Phone (248) 988-8085

1940 S Telegraph Rd
Bloomfield Hills, MI 48302
Phone (248) 409-0490

3050 Union Lake Rd
Ste 3C
Commerce Township, MI 48382
Phone (248) 363-8267

1485 N Michigan Ave
Ste 100
Howell, MI 48843
Phone (517) 545-5880

29480 Woodward Ave
Royal Oak, MI 48073
Phone (248) 541-8386

Interoperability endpoints

  • Direct secure messaging: rebecca.ammon.1@9974.direct.athenahealth.com
  • Direct secure messaging: rebecca.ammon.p4@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1083732432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29480 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730903",
            "telephone_number": "248-541-9121",
            "fax_number": "248-541-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMON",
        "first_name": "REBECCA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.