Melissa Prus, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

5501018949 Issued in MI

Practice address

6425 Harvey St
Norton Shores, MI 49444-9739

Phone

(317) 984-8662

Fax

(231) 798-6391

NPI assigned

Dec 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1215408745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-7135",
            "fax_number": "616-840-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "317-984-8662",
            "fax_number": "231-798-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUS",
        "first_name": "MELISSA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018949",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MI",
            "license": "5501018949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Pediatric Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.