Active NPI
Chaka Mathiea
- Physical Therapist
- Warren, MI
National Provider Identifier
1407066772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501005265
- Practice address
- 11554 E 12 Mile Rd
Warren, MI 48093-2644 - Phone
- (586) 558-0185
- Fax
- (586) 558-7128
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501005265 | MI | Primary |
Addresses
Primary practice location
11554 E 12 Mile Rd
Warren, MI 48093-2644
Mailing address
23228 Grayson Dr
Southfield, MI 48075-3690
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Laser Therapy PLC | Past | Accepting new patients | |
| Mobility Plus Rehab Services Inc. | Physical Therapist | Past | Accepting new patients |
| Mobility Plus Rehab Services, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Medicine & Rehabilitation Physician
- Oak Park, MI
- NPI 1891407524
-
- Rehabilitation Clinic/Center
- Troy, MI
- NPI 1255403598
Physical Therapist
-
- Physical Therapy Clinic/Center
- Troy, MI
- NPI 1518348606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407066772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23228 GRAYSON DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480753690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11554 E 12 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480932644",
"telephone_number": "586-558-0185",
"fax_number": "586-558-7128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIEA",
"first_name": "CHAKA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501005265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.