Individual provider Active NPI

Alissa Kristine Peters, PT, DPT, NCS, CBIS

  • Physical Therapist
  • West Bloomfield, MI
National Provider Identifier
1477055903
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016154 Issued in MI
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

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
Direct Messaging Address apeters703803@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230512001404 MI Practitioner - Physical Therapist in Private Practice 2567828742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016154MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Mi LLC Physical Therapist CurrentSince May 1, 2023 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.

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.

Verify at the official NPI Registry.