Individual provider Active NPI

Jordan Scott Ollenberger, DPT, PT

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1336628536
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4600 Investment Dr Ste 190
Troy, MI 48098-6365
Phone
(248) 353-1234
NPI assigned
Aug 8, 2018
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4600 Investment Dr Ste 190
Troy, MI 48098-6365

Mailing address

29255 Northwestern Hwy Ste 300
Southfield, MI 48034-5742
Phone (248) 353-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180913001566 MI Practitioner - Physical Therapist in Private Practice 0244580165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
67.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ompt Specialists, Inc. Physical Therapist CurrentSince Aug 20, 2018 Accepting new patients
Auto & Work Comp Rehab LLC Past Accepting new patients

Locations

1071 N Campbell Rd
Royal Oak, MI 48067

29255 Northwestern Hwy
Ste 300
Southfield, MI 48034
Phone (248) 354-9666

1080 Kirts Blvd
Ste 300
Troy, MI 48084

4600 Investment Dr
Ste 190
Troy, MI 48098
Phone (242) 353-1234

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1336628536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345742",
            "telephone_number": "248-353-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR STE 190",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-353-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLENBERGER",
        "first_name": "JORDAN",
        "middle_name": "SCOTT",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.