Michigan Physical Medicine and Rehabilitation, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5101012404 Issued in MI

Legal business name

MICHIGAN PHYSICAL MEDICINE AND REHABILITATION, P.C.

Practice address

20950 Harrington St
Clinton Township, MI 48036-1923

Phone

(586) 468-3900

Fax

(586) 468-9811

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michelle L Bradley, D.O.

Title

President

Phone

(586) 468-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• David D Bradley, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fargo, ND
  • NPI 1639294259
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1295741619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20950 HARRINGTON ST",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480361923",
            "telephone_number": "586-468-3900",
            "fax_number": "586-468-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20950 HARRINGTON ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361923",
            "telephone_number": "586-468-3900",
            "fax_number": "586-468-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PHYSICAL MEDICINE AND REHABILITATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-468-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101012404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "250E020580",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495487811",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Foot & Ankle Institute PC
• Michigan Hospital Physicians, PC
• Michigan MSK Medicine PLLC
• Michigan Neuro Diagnostics PC
• Michigan Neurology Associates
• Michigan Physical Therapy
• Michigan Rehab Consultant PC
• Michigan Surgical Group
• Michigan Urgent Care
• Blake Mico, LPC

• Physical Medicine & Rehabilitation Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.