Organization Active NPI

1St Priority Physical Therapy LLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Park, MI
National Provider Identifier
1134422363
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
1ST PRIORITY PHYSICAL THERAPY LLC
Practice address
21700 Greenfield Rd
Oak Park, MI 48237-2581
Phone
(248) 968-6899
NPI assigned
Dec 9, 2010
Last updated
Dec 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Mr. Malik Fuqua
Title
Owner
Phone
(248) 968-6899

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

21700 Greenfield Rd
Oak Park, MI 48237-2581

Mailing address

21700 Greenfield Rd
Oak Park, MI 48237-2581

National Provider Directory

National Provider Directory

Locations

21700 Greenfield Rd
Ste 21
Oak Park, MI 48237
Phone (248) 968-6899

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1134422363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21700 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21700 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372581",
            "telephone_number": "248-968-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST PRIORITY PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "FUQUA",
        "authorized_official_first_name": "MALIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-968-6899",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.