Endurance Rehabilitation & Athletics PLLC
Organization Active NPI Orthopedic Physical Therapist · Ada, MI
NPI 1508318296 · NPPES record last updated Dec 12, 2016
Key facts
- NPI
- 1508318296
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 5501012622 (MI)
- Legal business name
- ENDURANCE REHABILITATION & ATHLETICS PLLC
- Practice address
- 6440 Fulton St E
Suite 150
Ada, MI 49301-8449 - Phone
- (616) 307-9950
- NPI assigned
- Oct 27, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Adam Edwin Homolka, MPT
- Title
- Owner
- Phone
- (616) 307-9950
Practitioners 1
-
Adam Edwin Homolka, MPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161222000821 | MI | Part B Supplier - Clinic/Group Practice | 8527349901 |
Receives reassigned benefits from 1 practitioner Practice locations: Ada, MI |
National Provider Directory
Locations
6440 Fulton St E
Ste 150
Ada, MI 49301
Phone (616) 307-9950
6440 Fulton St E
Ada, MI 49301
5844 NW Barry Rd
Ste 310
Kansas City, MO 64154
Phone (816) 741-9122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 5501012622 | MI | |
| Sports Physical Therapist |
2251S0007X | 5501012622 | MI | |
| Orthopedic Physical Therapist |
2251X0800X | 5501012622 | MI | Yes |
Addresses
Primary practice location
6440 Fulton St E
Suite 150
Ada, MI 49301-8449
Mailing address
6440 Fulton St E
Suite 150
Ada, MI 49301-8449
Other providers in Ada, MI
- Michael Henry Dzirbowicz
- Faith Eaton
- Suzanne Michele Edwards
- Daniel Keith Ehnis
- Karen Marie Elbert
- Kathleen Ann Esch
- Evergreen Meadow Afc
- Travis James Faulkner
- Joseph Fazzio
- Karen Feaster
All providers in Ada, MI · Orthopedic Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.