Active NPI
Gregg Golden, PT
- Physical Therapist
- Warren, MI
National Provider Identifier
1407246143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501008399
- Practice address
- 30078 Schoenherr Rd Ste 200
Warren, MI 48088-3178 - Phone
- (586) 806-6284
- Fax
- (586) 806-6274
- NPI assigned
- Feb 3, 2015
- 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 | 5501008399 | MI | Primary |
Addresses
Primary practice location
30078 Schoenherr Rd Ste 200
Warren, MI 48088-3178
Mailing address
33900 Harper Ave
Suite 204
Clinton Township, MI 48035-4258
Phone (586) 416-9100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501008399 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1407246143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33900 HARPER AVE",
"address_2": "SUITE 204",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480354258",
"telephone_number": "586-416-9100",
"fax_number": "586-416-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30078 SCHOENHERR RD STE 200",
"city": "WARREN",
"state": "MI",
"postal_code": "480883178",
"telephone_number": "586-806-6284",
"fax_number": "586-806-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEN",
"first_name": "GREGG",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-03",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501008399",
"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 Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.