Active NPI
Craig Alvin Plonka, ATC
- Athletic Trainer
- Harper Woods, MI
National Provider Identifier
1225542301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601001171
- Practice address
- 19556 Harper Ave
Harper Woods, MI 48225-2037 - Phone
- (313) 885-6491
- NPI assigned
- Nov 28, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601001171 | MI | Primary |
Addresses
Primary practice location
19556 Harper Ave
Harper Woods, MI 48225-2037
Mailing address
8928 Louise St
Livonia, MI 48150-4016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601001171 | MI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VHS Rehabilitation Institute of Michigan Inc | Past | Accepting new patients | |
| Rehabilitation Institute of Michigan | Past | Accepting new patients |
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.
-
- Rehabilitation Clinic/Center
- Detroit, MI
- NPI 1982779260
-
- Rehabilitation Hospital
- Detroit, MI
- NPI 1871805150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511827200000",
"number": "1225542301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8928 LOUISE ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481504016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19556 HARPER AVE",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482252037",
"telephone_number": "313-885-6491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLONKA",
"first_name": "CRAIG",
"middle_name": "ALVIN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-28",
"last_updated": "2017-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601001171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harper Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.