Active NPI
Alissa Kristine Peters, PT, DPT, NCS, CBIS
- Physical Therapist
- West Bloomfield, MI
National Provider Identifier
1477055903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501016154
- Practice address
- 6777 W Maple Rd
West Bloomfield, MI 48322-3013 - Phone
- (248) 325-2146
- NPI assigned
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016154 | MI | Primary |
Addresses
Primary practice location
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Mailing address
535 E la Salle Ave
Royal Oak, MI 48073-3572
Phone (248) 765-5309
Other practice location 1
261 Mack Ave
Detroit, MI 48201-2417
Phone (313) 745-9793
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | apeters703803@direct.hfhs.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501016154 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services Mi LLC | Physical Therapist | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
Organizations & group practices 1
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.
-
- Physical Therapist
- Canton, MI
- NPI 1790324648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616544000000",
"number": "1477055903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 E LA SALLE AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480733572",
"telephone_number": "248-765-5309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6777 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223013",
"telephone_number": "248-325-2146"
}
],
"practiceLocations": [
{
"address_1": "261 Mack Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482012417",
"country_code": "US",
"telephone_number": "313-745-9793",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERS",
"first_name": "ALISSA",
"middle_name": "KRISTINE",
"credential": "PT, DPT, NCS, CBIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2021-03-24",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016154",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "apeters703803@direct.hfhs.org",
"affiliation": "N",
"address_1": "6777 W Maple Rd",
"city": "West Bloomfield",
"state": "MI",
"country_code": "US",
"postal_code": "483223013",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.