Kristie Mulder, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018238 Issued in MI

Practice address

317 E Wackerly St
Midland, MI 48642-7062

Phone

(989) 832-9300

Fax

(989) 832-9301

NPI assigned

Sep 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristie Koppinger Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benchmark Physical Therapy Michigan LLC

  • Physical Therapist
  • Midland, MI
  • NPI 1629740188
  Medicare reassignment NPD

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1437668050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 S LAPEER RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601433",
            "telephone_number": "248-814-8060",
            "fax_number": "248-814-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427062",
            "telephone_number": "989-832-9300",
            "fax_number": "989-832-9301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 S Main St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Freeland",
            "state": "MI",
            "postal_code": "486238935",
            "country_code": "US",
            "telephone_number": "989-695-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "KRISTIE",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIE",
            "last_name": "KOPPINGER",
            "credential": "DPT, CSCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Patrick Mowry
• Sean C Moylan, PA-C
• Stephanie Lynn Mrozinski
• David A Mulder, PA
• Elizabeth Mulder
• Jacki Mulligan
• Kassandra Mulligan
• Zachary Mulligan
• Hannah Marie Murley
• Christina L Murphy, DO

• Physical Therapist in Midland, MI
• Providers in Midland, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.