NPIMap

Organization Active NPI

Mendelson Kornblum Physical Therapy

  • Athletic Trainer
  • Warren, MI
National Provider Identifier
1114226222
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
L1862359 Issued in MI
Legal business name
MENDELSON KORNBLUM PHYSICAL THERAPY
Practice address
29703 Hoover Rd Ste a
Warren, MI 48093-8901
Phone
(586) 582-0340
NPI assigned
Mar 16, 2011
Last updated
Mar 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Katie Pring
Title
PT Suprivisor
Phone
(586) 582-0340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X L1862359 MI Primary

Addresses

Primary practice location

29703 Hoover Rd Ste a
Warren, MI 48093-8901

Mailing address

29703 Hoover Rd Ste a
Warren, MI 48093-8901
Phone (586) 582-0340

National Provider Directory

National Provider Directory
Tax ID family
Mendelson Orthopedic Physical Therapy18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1114226222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29703 HOOVER RD STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938901",
            "telephone_number": "586-582-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29703 HOOVER RD STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938901",
            "telephone_number": "586-582-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDELSON KORNBLUM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "PRING",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PT SUPRIVISOR",
        "authorized_official_telephone_number": "586-582-0340"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "L1862359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.