Individual provider Active NPI

Laura Kordick, DPT

  • Physical Therapist
  • Norton Shores, MI
National Provider Identifier
1114354669
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016432 Issued in MI
Practice address
945 E Sherman Blvd
Norton Shores, MI 49444-1805
Phone
(231) 737-4374
Fax
(231) 830-9196
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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 5501016432 MI Primary

Addresses

Primary practice location

945 E Sherman Blvd
Norton Shores, MI 49444-1805

Mailing address

945 E Sherman Blvd
Norton Shores, MI 49444-1805
Phone (231) 737-4374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131211000733 MI Practitioner - Physical Therapist in Private Practice 5890922249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Probility Therapy ServicesGroup PAC ID 6305897414, 106 clinicians

Practice addresses (Care Compare)

3145 W Clark Rd
Suite 102
Ypsilanti, MI 48197-1120
Phone 73471277022

990 W Ann Arbor TRL
Suite 103
Plymouth, MI 48170-1686
Phone (734) 414-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Probility Therapy Services CurrentSince Sep 1, 2015 Accepting new patients
Probility Therapy Services Physical Therapist CurrentSince Sep 1, 2015 Accepting new patients

Locations

2058 S State St
Ann Arbor, MI 48104
Phone (734) 913-0300

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

3145 W Clark Rd
Ste 102
Ypsilanti, MI 48197
Phone (734) 528-9760

3145 W Clark Rd
Ste 106
Ypsilanti, MI 48197
Phone (734) 528-9760

Organizations & group practices 2

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1114354669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441805",
            "telephone_number": "231-737-4374",
            "fax_number": "231-830-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441805",
            "telephone_number": "231-737-4374",
            "fax_number": "231-830-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDICK",
        "first_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.