NPIMap

Organization Active NPI

Michigan Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Mio, MI
National Provider Identifier
1467719252
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MICHIGAN PHYSICAL THERAPY, INC.
Practice address
124 South Morenci Street
Mio, MI 48647-1032
Phone
(989) 390-3718
Fax
(989) 826-6860
NPI assigned
Apr 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Mr. Jerry ParkerNPI 1083738140
Title
Officer
Phone
(989) 390-3718

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

124 South Morenci Street
Mio, MI 48647-1032

Mailing address

PO Box 1032
Mio, MI 48647-1032
Phone (989) 826-6830

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000235 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2163687104 Practice locations: Mio, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1467719252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1032",
            "city": "MIO",
            "state": "MI",
            "postal_code": "486471032",
            "telephone_number": "989-826-6830",
            "fax_number": "989-826-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SOUTH MORENCI STREET",
            "city": "MIO",
            "state": "MI",
            "postal_code": "486471032",
            "telephone_number": "989-390-3718",
            "fax_number": "989-826-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "989-390-3718",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.