Active NPI
Erin Boguslawski, DPT
- Physical Therapist
- Shelby Township, MI
National Provider Identifier
1104216936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501016169
- Practice address
- 14153 Rick Dr
Shelby Township, MI 48315-2951 - Phone
- (586) 566-0326
- NPI assigned
- Feb 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016169 | MI | Primary |
Addresses
Primary practice location
14153 Rick Dr
Shelby Township, MI 48315-2951
Mailing address
14153 Rick Dr
Shelby Township, MI 48315-2951
Phone (586) 566-0326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201118001373 | MT | Practitioner - Physical Therapist in Private Practice | 2163740614 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501016169 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422835200000",
"number": "1104216936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14153 RICK DR",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483152951",
"telephone_number": "586-566-0326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14153 RICK DR",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483152951",
"telephone_number": "586-566-0326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGUSLAWSKI",
"first_name": "ERIN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-02",
"last_updated": "2015-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.