Custom Fit Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CUSTOM FIT PHYSICAL THERAPY PLLC

Doing business as

Custom Fit Physical Therapy

Practice address

21669 Telegraph Rd
Brownstown TWP, MI 48183-1338

Phone

(734) 308-0289

NPI assigned

Jul 25, 2024

Last updated

Oct 8, 2024By 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

Melissa TaylorNPI 1578647723

Title

Physical Therapist

Phone

(734) 308-0289

Specialties & licenses 1

Addresses

Other names 1

• Custom Fit Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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.

• Melissa Christine Taylor, MPT

  • Physical Therapist
  • Brownstown TWP, MI
  • NPI 1578647723
  Medicare reassignment Care Compare group NPD Authorized official
• Bruno Gervasi, DPT

  • Physical Therapist
  • Allen Park, MI
  • NPI 1609115310
  Medicare reassignment Care Compare group NPD
• Jennifer Wheeler

  • Physical Therapist
  • Brownstown TWP, MI
  • NPI 1376653915
  Medicare reassignment Care Compare group NPD
• Brianna Lipa, DPT

  • Physical Therapist
  • Garden City, MI
  • NPI 1245923457
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1225866726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21669 TELEGRAPH RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831338",
            "telephone_number": "734-307-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21669 TELEGRAPH RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831338",
            "telephone_number": "734-308-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM FIT PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "734-308-0289"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Fit Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Custom Fit Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald Daniel Corne, D.C.
• Brianna Courtland
• Jeffrey Garret Cramblett, DPM
• Steven Crossley
• Crossover Health Medical Group (Crossover @ Brownstown)
• Wael Hussein Dabaja, D.O.
• Kenneth Jerome Dennis
• Andrew Joseph Dettore, D.O.
• Jignesh Dhananjay Dhrangadharia, P.T
• Discount Drugs LLC (Discount Drugs)

• Physical Therapist in Brownstown TWP, MI
• Providers in Brownstown TWP, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.