Individual provider Active NPI

Ann R Willette, DPT

  • Physical Therapist
  • Midland, MI
National Provider Identifier
1104057421
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014621 Issued in MI
Practice address
841 S Saginaw Rd
Midland, MI 48640-4664
Phone
(866) 625-3570
Fax
(866) 245-8064
NPI assigned
Aug 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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 5501014621 MI Primary

Addresses

Primary practice location

841 S Saginaw Rd
Midland, MI 48640-4664

Mailing address

PO Box 3497
Sturtevant, WI 53177-0300
Phone (877) 552-2996

Other identifiers 1

IdentifierTypeStateIssuer
1104057421MedicaidMI

Other names 1

  • Ann R Strom Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091020000743 MI Practitioner - Physical Therapist in Private Practice 3779620976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Rehab LLCGroup PAC ID 5799122032, 29 clinicians

Practice addresses (Care Compare)

7376 Glen Eagle Dr
Bay City, MI 48706-9316
Phone (989) 992-1367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Rehab LLC Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jul 6, 2025 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jul 6, 2025 Accepting new patients
Mid-Michigan Physical Therapy and Rehab Specialists, LLC Physical Therapist Past Accepting new patients

Locations

2885 10 Mile Rd NE
Rockford, MI 49341
Phone (616) 326-0010

7005 Pontiac Trl
West Bloomfield, MI 48323
Phone (248) 681-2476

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 4

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1104057421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531770300",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 S SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404664",
            "telephone_number": "866-625-3570",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETTE",
        "first_name": "ANN",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104057421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "STROM",
            "middle_name": "R",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.