NPIMap

Organization Active NPI

1St Choice Physical Therapy Clarkston Novi, LLC

  • Physical Therapist
  • Waterford, MI
National Provider Identifier
1336212315
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004083 Issued in MI
Legal business name
1ST CHOICE PHYSICAL THERAPY CLARKSTON NOVI, LLC
Practice address
5330 Dixie Hwy
Waterford, MI 48329-1692
Phone
(248) 623-0497
NPI assigned
Nov 16, 2006
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Peter R Kovacek, PTNPI 1700850252
Title
Member
Phone
(313) 492-4293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004083 MI Primary

Addresses

Primary practice location

5330 Dixie Hwy
Waterford, MI 48329-1692

Mailing address

5330 Dixie Hwy
Waterford, MI 48329-1692
Phone (248) 623-0497

National Provider Directory

National Provider Directory

Locations

5330 Dixie Hwy
Waterford, MI 48329
Phone (248) 623-0497

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1336212315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291692",
            "telephone_number": "248-623-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291692",
            "telephone_number": "248-623-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST CHOICE PHYSICAL THERAPY CLARKSTON NOVI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "KOVACEK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "313-492-4293",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.