Active NPI
Tbci PC
- Speech-Language Pathologist
- Troy, MI
National Provider Identifier
1285705095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- TBCI PC
- Practice address
- 1059 Owendale
Troy, MI 48083 - Phone
- (248) 526-0110
- Fax
- (248) 680-9138
- NPI assigned
- Nov 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas J Park, MD
- Title
- Medical Director
- Phone
- (248) 526-0110
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychiatry Physician | 2084P0800X | |||
| Physical Therapist | 225100000X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
1059 Owendale
Troy, MI 48083
Mailing address
1059 Owendale
Troy, MI 48083
Phone (248) 526-0110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30421 | Other | MI | BLUE CROSS |
Other names 1
- Traumatic Brain and Catastrophic Injury PC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1285705095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1059 OWENDALE",
"city": "TROY",
"state": "MI",
"postal_code": "48083",
"telephone_number": "248-526-0110",
"fax_number": "248-680-9138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1059 OWENDALE",
"city": "TROY",
"state": "MI",
"postal_code": "48083",
"telephone_number": "248-526-0110",
"fax_number": "248-680-9138"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TBCI PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-13",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "PARK",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "248-526-0110",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "30421",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Traumatic Brain and Catastrophic Injury PC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.