Chelsea Liane Petrakovitz, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017232 Issued in MI

Practice address

900 Cooper St
Jackson, MI 49202-3398

Phone

(517) 780-9500

NPI assigned

Oct 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Chelsea Liane Vader Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fit for You Physical Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Jackson, MI
  • NPI 1700542875
  NPD Authorized official

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1114493368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOLKS RD",
            "city": "HORTON",
            "state": "MI",
            "postal_code": "492469632",
            "telephone_number": "517-745-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COOPER ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023398",
            "telephone_number": "517-780-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAKOVITZ",
        "first_name": "CHELSEA",
        "middle_name": "LIANE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetrakovitz603536@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "VADER",
            "middle_name": "LIANE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi Lynn Peterson, CPSS, PSP
• Pamela Teresa Peterson, NP
• Taylar Peterson
• Maddelyn E Petosky
• Anna Petovello
• Derry Petty, LMT
• Joshua Pewsey
• Christopher C Pfeifer, D.O.
• Kelli Pfiester, CF-SLP
• Pharaoh'S Rest Haven, L.L.C

• Physical Therapist in Jackson, MI
• Providers in Jackson, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.