Active NPI
Thunder Bay Therapy & Sports Medicine, PLC
- Rehabilitation Clinic/Center
- Alpena, MI
National Provider Identifier
1386699031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Clinic/Center
- Legal business name
- THUNDER BAY THERAPY & SPORTS MEDICINE, PLC
- Practice address
- 348 Long Rapids PLZ
Alpena, MI 49707-1374 - Phone
- (989) 358-8086
- Fax
- (989) 354-2253
- NPI assigned
- May 23, 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
- Mrs. Teresa Lynn Duncan, PHYSCIAL THERAPIST
- Title
- Clinic Administrator
- Phone
- (989) 358-8086
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Primary |
Addresses
Primary practice location
348 Long Rapids PLZ
Alpena, MI 49707-1374
Mailing address
348 Long Rapids PLZ
Alpena, MI 49707-1374
Phone (989) 358-8086
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30720 | Other | MI | BLUE CROSS &BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040920000509 | MI | Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 8527036482 | Practice locations: Alpena, MI; Rogers City, MI |
National Provider Directory
National Provider Directory- Tax ID family
- Thunder Bay Fyzical Therapy and Balance Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Occupational Medicine Clinic/Center
- Alpena, MI
- NPI 1003203605
Locations
140 S Bradley Hwy
Rogers City, MI 49779
Phone (989) 734-7607
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Alpena, MI
- NPI 1356608145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196726400000",
"number": "1386699031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "348 LONG RAPIDS PLZ",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071374",
"telephone_number": "989-358-8086",
"fax_number": "989-354-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "348 LONG RAPIDS PLZ",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071374",
"telephone_number": "989-358-8086",
"fax_number": "989-354-2253"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THUNDER BAY THERAPY & SPORTS MEDICINE, PLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-23",
"last_updated": "2007-12-04",
"status": "A",
"authorized_official_last_name": "DUNCAN",
"authorized_official_first_name": "TERESA",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
"authorized_official_telephone_number": "989-358-8086",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "PHYSCIAL THERAPIST"
},
"taxonomies": [
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS &BS",
"identifier": "30720",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alpena, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.