NPIMap

Organization Active NPI

Ethos Physical Therapy LLC

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1225757719
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ETHOS PHYSICAL THERAPY LLC
Practice address
44191 Plymouth Oaks Blvd Ste 800
Plymouth, MI 48170-2538
Phone
(734) 463-3007
NPI assigned
Aug 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Authorized official

Name
Dan Mozes
Title
Owner
Phone
(734) 463-3007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

44191 Plymouth Oaks Blvd Ste 800
Plymouth, MI 48170-2538

Mailing address

44191 Plymouth Oaks Blvd Ste 800
Plymouth, MI 48170-2538
Phone (734) 463-3007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221220002280 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6507235298 Receives reassigned benefits from 7 practitioners
Practice locations: Plymouth, MI; South Lyon, MI

National Provider Directory

National Provider Directory

Locations

515 N Mill St
South Lyon, MI 48178
Phone (734) 463-3007

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1225757719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44191 PLYMOUTH OAKS BLVD STE 800",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702538",
            "telephone_number": "734-463-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44191 PLYMOUTH OAKS BLVD STE 800",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702538",
            "telephone_number": "734-463-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "MOZES",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-463-3007"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

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