Souva PT and Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOUVA PT AND PERFORMANCE LLC

Practice address

51220 Van Dyke Ave
Shelby Township, MI 48316-4440

Phone

(586) 210-0530

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Jacob Brad Souva, DPTNPI 1588303952

Title

Owner

Phone

(586) 569-1621

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Brad Souva

  • Physical Therapist
  • Royal Oak, MI
  • NPI 1588303952
  Medicare reassignment Authorized official
• Dominic Mora, PT, DPT

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1548126493
  Medicare reassignment

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1407564024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71575 JULIUS DR",
            "city": "BRUCE TOWNSHIP",
            "state": "MI",
            "postal_code": "480653187",
            "telephone_number": "586-569-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51220 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164440",
            "telephone_number": "586-210-0530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71575 Julius Dr",
            "address_purpose": "LOCATION",
            "city": "Bruce Township",
            "state": "MI",
            "postal_code": "480653187",
            "country_code": "US",
            "telephone_number": "586-569-1621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2615 Nakota Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480731816",
            "country_code": "US",
            "telephone_number": "586-210-0530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUVA PT AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "SOUVA",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-569-1621",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Michael Sommers
• Shikha Sood, DMD
• Caleb N Sorrell
• Aneta Sotirov, MD
• Milagros Sotomayor, MS OTR/L
• Julie Patricia Sowa, P.T.
• Specialty Medical Equipment Inc.
• Specific Chiropractic Inc.
• Andrew Spencer
• Barbara Gail Spencer, MSW CSW

• Physical Therapy Clinic/Center in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.