Glenna Donovan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018451 Issued in MI

Practice address

2085 W Grand River Ave Ste 103C
Okemos, MI 48864-1733

Phone

(517) 246-2626

Fax

(517) 721-7842

NPI assigned

Sep 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366
  Medicare reassignment Care Compare group NPD
• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD
• Michigan Rehabilitation Specialists of Fowlerville LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Fowlerville, MI
  • NPI 1669531166
  Medicare reassignment NPD
• Michigan Rehabilitation Specialists of Fowlerville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Dexter, MI
  • NPI 1407525892
  NPD
• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD
• Dwight Orthopedic Rehabilitation Co

  • Physical Therapist
  • Madison Heights, MI
  • NPI 1285651919
  NPD (past)

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1215446349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 W GRAND RIVER AVE STE 103C",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641733",
            "telephone_number": "517-246-2626",
            "fax_number": "517-721-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "GLENNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Mary Dohr, OD
• Aleesa Dominguez
• Domino Counseling Services LLC
• Shakaria Donald
• Solenne Donnelly, LLC
• Megan Donovan
• Haley Dawn Dontje
• Elaysia Dotson
• Doug Derdowski, LMSW LLC
• Adrianna Douglass

• Physical Therapist in Okemos, MI
• Providers in Okemos, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.