Champ Therapy and Wellness PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CHAMP THERAPY AND WELLNESS PLLC

Practice address

1817 Deer View CT
Howell, MI 48843-8091

Phone

(248) 921-7720

NPI assigned

Jan 4, 2022

Organization subpart

No

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

Authorized official

Name

Kelly Hogan, DPT, PT, MOT, OTR/LNPI 1356719504

Title

Owner

Phone

(248) 921-7720

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Kelly Hogan, DPT, PT, MOT, OTR/L

  • Physical Therapist
  • Howell, MI
  • NPI 1356719504
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1447911136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 DEER VIEW CT",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438091",
            "telephone_number": "248-921-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 DEER VIEW CT",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438091",
            "telephone_number": "248-921-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMP THERAPY AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-921-7720",
        "authorized_official_credential": "DPT, PT, MOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1356719504",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly@champtherapyandwellness.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1817 Deer View Ct",
            "city": "Howell",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488438091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine McAuley Health Services
• Brianna Kaitlyn Cavaleri, PT, DPT
• Lera-Jo Ann Cavanaugh, NNP
• Kory Martin Cesarz
• Faith Chaaban
• Colleen Ann Chapman, M.ED, LLP CAC
• Pilar Charles
• Ciara Lynn Charlick
• Kimberly K Charlick, PTA
• Sarahlouise Charnesky

• Physical Therapy Clinic/Center in Howell, MI
• Providers in Howell, 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 Jan 24, 2022; 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.