Individual provider Active NPI

Ron Zachariah, DPT, GCOMPT, CLT

  • Physical Therapist
  • Warren, MI
National Provider Identifier
1396920443
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013556 Issued in MI
Practice address
Horizon Medical Building
13251 E Ten Mile Road Suite 400
Warren, MI 48089
Phone
(586) 759-7474
Fax
(586) 759-7476
NPI assigned
Jan 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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 5501013556 MI Primary

Addresses

Primary practice location

Horizon Medical Building
13251 E Ten Mile Road Suite 400
Warren, MI 48089

Mailing address

31370 Harper Ave
St Clair Shores, MI 48082
Phone (586) 285-0545

Other identifiers 1

IdentifierTypeStateIssuer
5501013556OtherMIBOARD OF PHYSICAL THERAPY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rzachariah16481@direct.hfhs.org

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
5501013556MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients
Complete Care Rehab LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1396920443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31370 HARPER AVE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-285-0545",
            "fax_number": "586-279-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HORIZON MEDICAL BUILDING",
            "address_2": "13251 E TEN MILE ROAD SUITE 400",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48089",
            "telephone_number": "586-759-7474",
            "fax_number": "586-759-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "RON",
        "name_prefix": "Mr.",
        "credential": "DPT, GCOMPT, CLT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHYSICAL THERAPY",
            "identifier": "5501013556",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rzachariah16481@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "Horizon Medical Building",
            "address_2": "13251 E Ten Mile Road Suite 400",
            "city": "Warren",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.