NPIMap

Organization Active NPI

Max Well Therapy LLC

Doing business as Max Well Physical Therapy

  • Physical Therapist
  • Grand Blanc, MI
National Provider Identifier
1407042963
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004033 Issued in MI
Legal business name
MAX WELL THERAPY LLC
Doing business as
Max Well Physical Therapy
Practice address
8263 S Saginaw St Ste 5
Grand Blanc, MI 48439-2462
Phone
(810) 230-9750
NPI assigned
Sep 19, 2007
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Jillayne M Maxwell, PTNPI 1083647895
Title
Owner
Phone
(810) 579-7184

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 5501004033 MI Primary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

8263 S Saginaw St Ste 5
Grand Blanc, MI 48439-2462

Mailing address

1289 S Linden Rd Ste a
Flint, MI 48532-3499
Phone (810) 230-9750

Other names 1

  • Max Well Physical Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.maxwelltherapy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000771 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7113825670 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Blanc, MI; Flint, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1397 S Linden Rd
Ste 180
Flint, MI 48532
Phone (810) 230-9750

5431 Hill 23 Dr
Flint, MI 48507
Phone (810) 238-9688

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1407042963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 S LINDEN RD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323499",
            "telephone_number": "810-230-9750",
            "fax_number": "810-230-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8263 S SAGINAW ST STE 5",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392462",
            "telephone_number": "810-230-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX WELL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "JILLAYNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-579-7184",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004033",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.maxwelltherapy.com",
            "affiliation": "N",
            "address_1": "8263 S Saginaw St Ste 5",
            "city": "Grand Blanc",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484392462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Max Well Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Max Well Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.

Verify at the official NPI Registry.