Great Lakes Pediatric Therapy

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

GREAT LAKES PEDIATRIC THERAPY

Practice address

356 Frank Rd
Frankenmuth, MI 48734-1258

Phone

(989) 372-6404

NPI assigned

Jan 11, 2024

Organization subpart

No

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

Authorized official

Name

Jessica Barry, PT, DPTNPI 1346659612

Title

Owner, Pediatric Physical Therapist

Phone

(989) 372-6404

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jessica Susan Barry, PT, DPT

  • Physical Therapist
  • Raleigh, NC
  • NPI 1346659612
  NPD Authorized official

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1497526271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 FRANK RD",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 FRANK RD",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341258",
            "telephone_number": "989-372-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER, PEDIATRIC PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "989-372-6404",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gorges Life Chiropractic, LLC
• Candace C Gorges, DC. MS.
• Emmily Granett, M.S., CRNA
• Janet Gray, LPC
• Great Lakes Eye Institute
• Mark G Greenwell, MD
• Timothy Hallie Greenwood Jr., DC
• Joshua Steven Grimmer
• Kenneth Merritt Groves, D.D.S.
• Megan Hansen, LMSW-C

• Pediatric Physical Therapist in Frankenmuth, MI
• Providers in Frankenmuth, MI by specialty
• Pediatric Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.