Individual provider Active NPI

Christine S Mullins, LPTA

  • Physical Therapy Assistant
  • Monroe, MI
National Provider Identifier
1316291032
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502003717 Issued in MI
Practice address
580 N Telegraph Rd Unit B
Monroe, MI 48162-3337
Phone
(734) 430-8330
Fax
(734) 430-8331
NPI assigned
Nov 2, 2012
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502003717 MI Primary

Addresses

Primary practice location

580 N Telegraph Rd Unit B
Monroe, MI 48162-3337

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Other names 1

  • Christine Connally Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5502003717MIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC CurrentSince Jul 16, 2023 Accepting new patients
Team Rehabilitation Services, LLC PastSince Jul 16, 2023 Accepting new patients

Locations

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

580 N Telegraph Rd
Unit B
Monroe, MI 48162
Phone (734) 430-8330

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1316291032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 N TELEGRAPH RD UNIT B",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623337",
            "telephone_number": "734-430-8330",
            "fax_number": "734-430-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "CHRISTINE",
        "middle_name": "S",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "CONNALLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.