Individual provider Active NPI

Dave Walters

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1528081767
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006205 Issued in MI
Practice address
3144 John R Rd
Suite 200
Troy, MI 48083-5930
Phone
(248) 743-0850
Fax
(248) 743-0851
NPI assigned
Jul 26, 2006
Last updated
Feb 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501006205 MI Primary

Addresses

Primary practice location

3144 John R Rd
Suite 200
Troy, MI 48083-5930

Mailing address

13464 Culver Dr
Shelby Township, MI 48315-5371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000308 MI Practitioner - Physical Therapist in Private Practice 7113935222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
1St Choice Physical Therapy Troy LLCGroup PAC ID 7911088604, 7 clinicians

Practice addresses (Care Compare)

3144 John R Rd
Suite 200
Troy, MI 48083-5936
Phone (248) 743-0850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501006205MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
1St Choice Physical Therapy, LLC Physical Therapist CurrentSince Feb 20, 2018 Accepting new patients
HC Rehab Solutions LLC Physical Therapist Past Accepting new patients
In Home Rehab,LLC Physical Therapist PastSince Jan 1, 2003 Accepting new patients

Locations

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

43737 Schoenherr Rd
Sterling Hts, MI 48313
Phone (586) 247-1178

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1528081767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13464 CULVER DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 JOHN R RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835930",
            "telephone_number": "248-743-0850",
            "fax_number": "248-743-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "DAVE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.