NPIMap

Organization Active NPI

Dynamic Rehab, LLC

  • Physical Therapy Clinic/Center
  • Southfield, MI
National Provider Identifier
1255867222
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DYNAMIC REHAB, LLC
Practice address
15700 Providence Dr
400
Southfield, MI 48075-3144
Phone
(248) 233-6467
Fax
(248) 415-6289
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Sujit John
Title
Admin
Phone
(248) 233-6467

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MI
Developmentally Disabled Services Day Training Agency 251C00000X MI
Physical Therapy Clinic/Center 261QP2000X MI Primary
Durable Medical Equipment & Medical Supplies 332B00000X MI
Private Vehicle 347C00000X MI

Addresses

Primary practice location

15700 Providence Dr
400
Southfield, MI 48075-3144

Mailing address

15700 Providence Dr
400
Southfield, MI 48075-3144
Phone (248) 233-6467

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1255867222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15700 PROVIDENCE DR",
            "address_2": "400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753144",
            "telephone_number": "248-233-6467",
            "fax_number": "248-415-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 PROVIDENCE DR",
            "address_2": "400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753144",
            "telephone_number": "248-233-6467",
            "fax_number": "248-415-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "SUJIT",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "248-233-6467"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

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

Verify at the official NPI Registry.