Ivyrehab Michigan, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

IVYREHAB MICHIGAN, LLC

Practice address

12319 Highland Rd Ste 501
Hartland, MI 48353-2946

Phone

(810) 991-1211

Fax

(810) 991-1656

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Ashley Griffiths

Title

Director of Payer Relations

Phone

(914) 294-4050

Specialties & licenses 1

Addresses

Tax ID family

Ivyrehab Michigan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120
  NPD tax ID

Locations

Practitioners 2

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

• Kayla Grabowski, BCBA

  • Behavior Analyst
  • Hartland, MI
  • NPI 1679051650
  NPD (past)
• Luke Frederick Gray, PA-C

  • Physician Assistant
  • Harbor Springs, MI
  • NPI 1710456280
  NPD (past)

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1508519489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-265-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12319 HIGHLAND RD STE 501",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532946",
            "telephone_number": "810-991-1211",
            "fax_number": "810-991-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYREHAB MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFITHS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "914-294-4050"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audree Adele Hulick
• Sarah Huschke-Struhar, BCBA
• Alexandria Ariana Husted
• Joy E Inyang, M.D.
• Heather Isaacson
• Morgan Jeffries
• John R Cabell DDS PC
• Ashley Johnson
• Erika M Johnson, D.D.S.
• Jenna Mary-Jean Johnson

• Behavior Analyst in Hartland, MI
• Providers in Hartland, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.