Xperience Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

XPERIENCE PHYSICAL THERAPY PLLC

Practice address

1352 US Highway 2
Crystal Falls, MI 49920-1047

Phone

(906) 874-1124

Fax

(906) 874-2124

NPI assigned

Jan 26, 2022

Last updated

Mar 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nicki Lee PriceNPI 1548761158

Title

PT

Phone

(906) 284-3497

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

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.

• Nicki Lee Price, PT

  • Physical Therapist
  • Iron River, MI
  • NPI 1548761158
  Medicare reassignment Care Compare group NPD Authorized official
• Selena Nicole Fuller, DPT

  • Physical Therapist
  • Crystal Falls, MI
  • NPI 1568073377
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1154073690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 US HIGHWAY 2",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201047",
            "telephone_number": "906-874-1124",
            "fax_number": "906-874-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 US HIGHWAY 2",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201047",
            "telephone_number": "906-874-1124",
            "fax_number": "906-874-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XPERIENCE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "NICKI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "906-284-3497",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Wilfred Smith, D.O.
• Gabriel John Smith, PA-C
• Table for One Massage Therapy
• TDS Health Services Inc
• TDS Inc (Crystal Falls Pharmacy)

• Physical Therapist in Crystal Falls, MI
• Providers in Crystal Falls, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.