Kasey M Moreno, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501013219 Issued in MI

Practice address

10078 Lapeer Rd Ste B
Davison, MI 48423-9031

Phone

(810) 653-6200

Fax

(810) 653-6226

NPI assigned

Mar 22, 2007

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

• Kasey M McLean Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Advanced Physical Therapy Center, Inc

  • Physical Therapist
  • Grand Blanc, MI
  • NPI 1154331262
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1467578112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10078 LAPEER RD STE B",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484239031",
            "telephone_number": "810-653-6200",
            "fax_number": "810-653-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "KASEY",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "MCLEAN",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Miller
• Demetrius Miller, PTA
• Ryan Mitchell, PTA
• Salwa Sirelkatim Mohamedahmed, MD
• Elizabeth Lyn Montney
• Donald Morgan
• Lynnette Andrea Mueller, RRT
• Rahshemeer Joachim Neal
• Thomas A Needham, RPH
• Hannah Mae Nettleton, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.