Individual provider Active NPI

Muthuvinayagam Murugan, RPT

  • Physical Therapist
  • Port Huron, MI
National Provider Identifier
1194845792
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007626 Issued in MI
Practice address
3403 Lapeer Rd Ste B101
Port Huron, MI 48060-3013
Phone
(810) 984-4131
Fax
(810) 984-1612
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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 5501007626 MI Primary

Addresses

Primary practice location

3403 Lapeer Rd Ste B101
Port Huron, MI 48060-3013

Mailing address

3048 Oak Moss CT
Fort Gratiot, MI 48059-3865
Phone (810) 385-9366

Other practice location 1

718 Huron Ave
Port Huron, MI 48060-3704
Phone (810) 966-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501007626MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Physical Therapy and Rehab Services Inc. Current Accepting new patients

Locations

718 Huron Ave
Port Huron, MI 48060
Phone (810) 966-8500

Organizations & group practices 1

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1194845792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 OAK MOSS CT",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593865",
            "telephone_number": "810-385-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 LAPEER RD STE B101",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603013",
            "telephone_number": "810-984-4131",
            "fax_number": "810-984-1612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Huron Ave",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480603704",
            "country_code": "US",
            "telephone_number": "810-966-8500",
            "fax_number": "810-966-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURUGAN",
        "first_name": "MUTHUVINAYAGAM",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.