Individual provider Active NPI

Michael Dennis Coulter, P.T.

  • Physical Therapist
  • Perrysburg, OH
National Provider Identifier
1104047844
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6191 Issued in OH
Practice address
27064 Oakmead Drive
Perrysburg, OH 43551-2657
Phone
(419) 874-6957
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 PT6191 OH Primary

Addresses

Primary practice location

27064 Oakmead Drive
Perrysburg, OH 43551-2657

Mailing address

7767 Westcroft Drive
Sylvania, OH 43560-1863
Phone (419) 517-4255

Other identifiers 3

IdentifierTypeStateIssuer
000000272642OtherOHANTHEM
2308185MedicaidOH
341952632-00OtherOHWORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140516001127 OH Practitioner - Physical Therapist in Private Practice 5092938266 Reassigns benefits to 5 organizations
I20210525003191 MI Practitioner - Physical Therapist in Private Practice 5092938266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Toledo College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Link LLCGroup PAC ID 4587805940, 27 clinicians

Practice addresses (Care Compare)

1038 N Monroe St
Monroe, MI 48162-3113
Phone (419) 559-5591

3203 N Adrian Hwy
Adrian, MI 49221-1113
Phone (419) 559-5591

3333 Sterns Rd
Lambertville, MI 48144-9738
Phone (419) 559-5591

3337 W Sterns Rd
Lambertville, MI 48144-9738
Phone (419) 559-5591

4210 W Sylvania Ave
Suite 102
Toledo, OH 43623-4501
Phone (419) 350-3347

4349 Talmadge Rd
Toledo, OH 43623-3527

902 Industrial Dr
Tecumseh, MI 49286-9701
Phone (419) 559-5591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6191OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Pain Services, PLL CurrentSince Aug 1, 2013 Accepting new patients
Brent L. Rubin & Associates Inc CurrentSince May 1, 2014 Accepting new patients
PT Link LLC Physical Therapist CurrentSince Mar 24, 2014 Accepting new patients
Toledo Pain Services, PLL CurrentSince Aug 1, 2013 Accepting new patients
Sandusky Wellness Center Inc CurrentSince May 1, 2018 Accepting new patients
Hallett Enterprises, LLC Physical Therapist PastSince Mar 24, 2014 Accepting new patients
Brent L. Rubin & Associates Inc PastSince Aug 11, 2019 Accepting new patients
Physical Therapy Consultants of Perrysburg, LLC Past Accepting new patients
Sandusky Wellness DME LLC Past Accepting new patients

Locations

3333 Sterns Rd
Lambertville, MI 48144
Phone (734) 568-6917

902 Industrial Dr
Tecumseh, MI 49286
Phone (517) 423-7722

11301 Upper Gilchrist Rd
Ste A
Mount Vernon, OH 43050
Phone (740) 392-1407

846 S Coy Rd
Ste 100
Oregon, OH 43616

1090 W South Boundary St
Ste 600
Perrysburg, OH 43551
Phone (419) 873-8280

3703 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-8085

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

6469 Monroe St
Sylvania, OH 43560

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

4349 Talmadge Rd
Toledo, OH 43623
Phone (419) 654-8818

3055 W Sylvania Ave
Toledo, OH 43613
Phone (419) 471-1172

5151 Monroe St
Ste 104
Toledo, OH 43623

3400 Meijer Dr
Toledo, OH 43617
Phone (419) 531-3500

7055 W Central Ave
Toledo, OH 43617

4210 W Sylvania Ave
Ste 102
Toledo, OH 43623
Phone (419) 350-3347

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9045/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104047844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7767 WESTCROFT DRIVE",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601863",
            "telephone_number": "419-517-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27064 OAKMEAD DRIVE",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512657",
            "telephone_number": "419-874-6957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "MICHAEL",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT6191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000272642",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2308185",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "341952632-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.