NPIMap

Organization Active NPI

Pro Active Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Farmington Hills, MI
National Provider Identifier
1437117934
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PRO ACTIVE PHYSICAL THERAPY INC.
Practice address
29991 Fernhill Dr
Farmington Hills, MI 48334-2031
Phone
(248) 345-7110
Fax
(248) 809-4030
NPI assigned
May 3, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Authorized official

Name
Mr. David Mark Roer, P.T.NPI 1538159025
Title
President
Phone
(248) 345-7110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

29991 Fernhill Dr
Farmington Hills, MI 48334-2031

Mailing address

29991 Fernhill Dr
Farmington Hills, MI 48334-2031
Phone (248) 345-7110

National Provider Directory

National Provider Directory

Locations

21700 Northwestern Hwy
Ste 110
Southfield, MI 48075
Phone (248) 345-7110

Practitioners & affiliated clinicians

Practitioners 5

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1437117934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29991 FERNHILL DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342031",
            "telephone_number": "248-345-7110",
            "fax_number": "248-809-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29991 FERNHILL DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342031",
            "telephone_number": "248-345-7110",
            "fax_number": "248-809-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ACTIVE PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "ROER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-345-7110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.