NPIMap

Organization Active NPI

Thera-Peds

  • Physical Therapy Clinic/Center
  • Macomb, MI
National Provider Identifier
1508202151
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THERA-PEDS
Practice address
16137 Leone Dr
Macomb, MI 48042-4063
Phone
(586) 566-0326
Fax
(586) 566-0573
NPI assigned
May 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Catherine Kelley
Title
Owner
Phone
(586) 212-3137

Specialties & licenses 1

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

Addresses

Primary practice location

16137 Leone Dr
Macomb, MI 48042-4063

Mailing address

16137 Leone Dr
Macomb, MI 48042-4063
Phone (586) 566-0326

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411001829 MI Part B Supplier - Clinic/Group Practice 1254563992 Receives reassigned benefits from 11 practitioners
Practice locations: Macomb, MI

National Provider Directory

National Provider Directory

Locations

16137 Leone Dr
Macomb, MI 48042
Phone (586) 566-0326

14153 Rick Dr
Shelby Township, MI 48315
Phone (586) 566-0326

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1508202151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16137 LEONE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424063",
            "telephone_number": "586-566-0326",
            "fax_number": "586-566-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16137 LEONE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424063",
            "telephone_number": "586-566-0326",
            "fax_number": "586-566-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA-PEDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-212-3137"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.