Organization Active NPI

P.T. Services Rehabilitation, Inc.

  • Physical Therapy Clinic/Center
  • Monroe, MI
National Provider Identifier
1477555142
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
P.T. SERVICES REHABILITATION, INC.
Practice address
15555 S Telegraph Rd
Suite 13
Monroe, MI 48161-4000
Phone
(419) 447-7203
Fax
(419) 447-5577
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tina M. Deitemeyer, CCA
Title
Administrator
Phone
(419) 447-7203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MI Primary

Addresses

Primary practice location

15555 S Telegraph Rd
Suite 13
Monroe, MI 48161-4000

Mailing address

PO Box 833
Tiffin, OH 44883-0833
Phone (419) 447-7203

Other identifiers 1

IdentifierTypeStateIssuer
3032465MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477555142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 833",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448830833",
            "telephone_number": "419-447-7203",
            "fax_number": "419-447-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15555 S TELEGRAPH RD",
            "address_2": "SUITE 13",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481614000",
            "telephone_number": "419-447-7203",
            "fax_number": "419-447-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.T. SERVICES REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEITEMEYER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "419-447-7203",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3032465",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.