NPIMap

Organization Active NPI

Great Lakes Therapy Housecalls, P.C.

Doing business as Great Lakes Physical Therapy Center

  • Rehabilitation Clinic/Center
  • Traverse City, MI
National Provider Identifier
1093069734
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
GREAT LAKES THERAPY HOUSECALLS, P.C.
Doing business as
Great Lakes Physical Therapy Center
Practice address
9731 E Cherry Bend Rd
Ste a
Traverse City, MI 49684-7621
Phone
(231) 941-8100
Fax
(231) 995-9297
NPI assigned
Nov 2, 2012
Last updated
Nov 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Mr. James Harvey, P.T.
Title
President / Administrator
Phone
(231) 941-8100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

9731 E Cherry Bend Rd
Ste a
Traverse City, MI 49684-7621

Mailing address

3281 Racquet Club Dr Unit a
Traverse City, MI 49684-4701
Phone (231) 941-8100

Other names 1

  • Great Lakes Physical Therapy Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address greatlakes@glhha.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120827000773 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7719876580 1 other NPI on this enrollment
Practice locations: Traverse City, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093069734. Details of each certification follow.

  • CCN 236863 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 236863

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GREAT LAKES PHYSICAL THERAPY CENTER
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 12, 2013
Last certification
Nov 7, 2019
Ownership / control type
Proprietary
Facility address
9731 E Cherry Road, Ste a
Traverse City, MI 49684

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Housecalls PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1105 E Eighth St
Traverse City, MI 49686
Phone (231) 941-8110

214 N Division St
Traverse City, MI 49684
Phone (231) 995-9748

3281 Racquet Club Dr
Unit A
Traverse City, MI 49684
Phone (231) 421-5036

9731 E Cherry Bend Rd
Ste A
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: greatlakes@glhha.com

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1093069734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3281 RACQUET CLUB DR UNIT A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844701",
            "telephone_number": "231-941-8100",
            "fax_number": "231-941-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9731 E CHERRY BEND RD",
            "address_2": "STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847621",
            "telephone_number": "231-941-8100",
            "fax_number": "231-995-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES THERAPY HOUSECALLS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-02",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT / ADMINISTRATOR",
        "authorized_official_telephone_number": "231-941-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "greatlakes@glhha.com",
            "affiliation": "N",
            "endpointDescription": "Great Lakes Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "9731 E Cherry Bend Rd",
            "address_2": "STE A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496847621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Great Lakes Physical Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Physical Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.