Individual provider Active NPI

Malorie Lynn Vasseur, DPT

  • Physical Therapist
  • Portage, MI
National Provider Identifier
1396469649
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302161 Issued in MI
Practice address
6016 Lovers LN Ste 3
Portage, MI 49002-3050
Phone
(269) 329-0934
NPI assigned
Sep 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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 5501302161 MI Primary

Addresses

Primary practice location

6016 Lovers LN Ste 3
Portage, MI 49002-3050

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501302161MIMDPhysical Therapist
15020TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6816 Charlotte Pike
Ste 103
Nashville, TN 37209
Phone (615) 356-0710

6736 Charlotte Pike
Ste 102
Nashville, TN 37209
Phone (615) 942-7783

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1396469649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 LOVERS LN STE 3",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023050",
            "telephone_number": "269-329-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSEUR",
        "first_name": "MALORIE",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.