NPIMap

Organization Active NPI

Life in Balance Inc

  • Physical Therapist
  • Niles, MI
National Provider Identifier
1417056318
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010439 Issued in MI
Legal business name
LIFE IN BALANCE INC
Practice address
20 N 2ND St
Suite 3
Niles, MI 49120-2259
Phone
(269) 687-9594
Fax
(269) 687-9543
NPI assigned
Sep 21, 2006
Last updated
Jun 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Mr. Alex Markovich, MS PTNPI 1922116375
Title
President Owner
Phone
(269) 687-9594

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010439 MI Primary

Addresses

Primary practice location

20 N 2ND St
Suite 3
Niles, MI 49120-2259

Mailing address

20 N 2ND St
Suite 3
Niles, MI 49120-2259
Phone (269) 687-9594

Other names 1

  • Life In Balance Physical Therapy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000347 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3870546922 Receives reassigned benefits from 2 practitioners
Practice locations: Niles, MI

National Provider Directory

National Provider Directory

Locations

20 N 2nd St
Ste 3
Niles, MI 49120
Phone (269) 687-9594

410 N 2nd St
Niles, MI 49120
Phone (269) 687-9594

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1417056318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N 2ND ST",
            "address_2": "SUITE 3",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202259",
            "telephone_number": "269-687-9594",
            "fax_number": "269-687-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N 2ND ST",
            "address_2": "SUITE 3",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202259",
            "telephone_number": "269-687-9594",
            "fax_number": "269-687-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE IN BALANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "MARKOVICH",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "269-687-9594",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life In Balance Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.