Individual provider Active NPI

Kortney Gregory, PT

  • Physical Therapist
  • Lapeer, MI
National Provider Identifier
1215473608
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018024 Issued in MI
Practice address
1739 N Saginaw St Ste 103
Lapeer, MI 48446-7627
Phone
(810) 660-7754
Fax
(810) 660-8254
NPI assigned
Jan 10, 2017
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 5501018024 MI Primary

Addresses

Primary practice location

1739 N Saginaw St Ste 103
Lapeer, MI 48446-7627

Mailing address

3379 Lum Rd
Lapeer, MI 48446-8342
Phone (810) 310-0984

Other practice location 1

2138 Fairway Dr
Davison, MI 48423-8482
Phone (810) 412-5100

Other names 1

  • Kortney Smith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227001337 MI Practitioner - Physical Therapist in Private Practice 9436410800 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Mar 1, 2018 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
Advanced Physical Therapy Center, Inc Physical Therapist Past Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

5832 N Lapeer Rd
Ste Abc
North Branch, MI 48461
Phone (810) 793-5282

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1215473608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 LUM RD",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484468342",
            "telephone_number": "810-310-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 N SAGINAW ST STE 103",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484467627",
            "telephone_number": "810-660-7754",
            "fax_number": "810-660-8254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2138 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Davison",
            "state": "MI",
            "postal_code": "484238482",
            "country_code": "US",
            "telephone_number": "810-412-5100",
            "fax_number": "810-412-5106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "KORTNEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORTNEY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.