Individual provider Active NPI

Stephanie Danielle Betts, DPT

  • Physical Therapist
  • Farmington Hills, MI
National Provider Identifier
1205090636
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22574 Issued in MD
Practice address
30055 Northwestern Hwy Ste 101
Farmington Hills, MI 48334-3260
Phone
(248) 865-4444
Fax
(248) 865-4121
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 22574 MD Primary

Addresses

Primary practice location

30055 Northwestern Hwy Ste 101
Farmington Hills, MI 48334-3260

Mailing address

30055 Northwestern Hwy Ste 101
Farmington Hills, MI 48334-3260
Phone (248) 865-4444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811000472 MI Practitioner - Physical Therapist in Private Practice 2365867124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Ear Institute PLLCGroup PAC ID 5597735514, 35 clinicians

Practice addresses (Care Compare)

30055 Northwestern Hwy
Suite 101
Farmington Hills, MI 48334-3260
Phone (248) 865-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22574MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Jul 29, 2020 Accepting new patients
Michigan Ear Institute PLLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients

Locations

30055 Northwestern Hwy
Ste 101
Farmington Hills, MI 48334
Phone (248) 865-4166

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21058/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephanie.betts.1@21058.direct.athenahealth.com

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1205090636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 101",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343260",
            "telephone_number": "248-865-4444",
            "fax_number": "248-865-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 101",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343260",
            "telephone_number": "248-865-4444",
            "fax_number": "248-865-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTS",
        "first_name": "STEPHANIE",
        "middle_name": "DANIELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.