JMK Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

JMK PHYSICAL THERAPY PLLC

Practice address

2120 15 Mile Road
Sterling Heights, MI 48310

Phone

(609) 903-8593

NPI assigned

Dec 6, 2023

Last updated

Dec 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Banoub, PHDNPI 1740647858

Title

Owner

Phone

(609) 903-8593

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Banoub, P.T., PHD.

  • Physical Therapist
  • Rochester, MI
  • NPI 1740647858
  Medicare reassignment Care Compare group NPD Authorized official
• Nahed Farg

  • Physical Therapist
  • Rochester Hills, MI
  • NPI 1649738568
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1215704655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3896 DEER SPRINGS DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064732",
            "telephone_number": "609-903-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 15 MILE ROAD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48310",
            "telephone_number": "609-903-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMK PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "BANOUB",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-903-8593",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica R Jiddou-Patros, M.D.
• Ziad Z Jiddou, PHARMD
• Reta Jimaa
• Limin Jin
• Jmhct Enterprise, LLC (Slow Down Transportation, LLC)
• Muhib Joda
• Larisa Spielberg Joeright, P.A.
• John D. Dinka, D.D.S. & Catherine M. Osinski Dinka, D.D.S. P.C.
• John R Verbovsky DO PC
• John S Demare DO PC

• Physical Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.