NPIMap

Organization Active NPI

Diversified Physical Therapy Specialists Inc

  • Physical Therapist
  • Frankenmuth, MI
National Provider Identifier
1104909316
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DIVERSIFIED PHYSICAL THERAPY SPECIALISTS INC
Practice address
193 E Jefferson Street
Frankenmuth, MI 48734-1935
Phone
(989) 652-4040
Fax
(989) 652-4703
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Ms. Theresa M MadayNPI 1154596807
Title
Administrator Phsyical Therapists
Phone
(989) 652-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

193 E Jefferson Street
Frankenmuth, MI 48734-1935

Mailing address

193 E Jefferson Street
Frankenmuth, MI 48734-1935
Phone (989) 652-4040

Other identifiers 2

IdentifierTypeStateIssuer
3251891MedicaidMI
30626OtherBC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1104909316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 E JEFFERSON STREET",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341935",
            "telephone_number": "989-652-4040",
            "fax_number": "989-652-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 E JEFFERSON STREET",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341935",
            "telephone_number": "989-652-4040",
            "fax_number": "989-652-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PHYSICAL THERAPY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "MADAY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR PHSYICAL THERAPISTS",
        "authorized_official_telephone_number": "989-652-4040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3251891",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "30626",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankenmuth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.