NPIMap

Organization Active NPI

Munger Physical Therapy, PLC

Doing business as Munger Physical Therapy

  • Physical Therapy Clinic/Center
  • Fort Gratiot, MI
National Provider Identifier
1548428626
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5501004051 Issued in MI
Legal business name
MUNGER PHYSICAL THERAPY, PLC
Doing business as
Munger Physical Therapy
Practice address
4351 24TH Ave
Suite 1
Fort Gratiot, MI 48059-4506
Phone
(810) 385-7405
Fax
(810) 385-7420
NPI assigned
May 27, 2008
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Mr. Markus Michael Munger, PTNPI 1225219561
Title
Owner/ Administrator
Phone
(810) 385-7405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 5501004051 MI Primary

Addresses

Primary practice location

4351 24TH Ave
Suite 1
Fort Gratiot, MI 48059-4506

Mailing address

4351 24TH Ave
Suite 1
Fort Gratiot, MI 48059-4506
Phone (810) 385-7405

Other identifiers 1

IdentifierTypeStateIssuer
65-0-G4-1223-0OtherMIBLUE CROSS AND BLUS SHIELD OF MICHIGAN

Other names 1

  • Munger Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140204001900 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6204906852 Receives reassigned benefits from 9 practitioners
Practice locations: Clinton Township, MI; Fort Gratiot, MI

National Provider Directory

National Provider Directory

Locations

44925 Morley Dr
Clinton Twp, MI 48036
Phone (586) 846-4320

4351 24th Ave
Ste 1
Fort Gratiot, MI 48059
Phone (810) 385-7405

4351 24th Ave
Ste 5
Fort Gratiot, MI 48059
Phone (810) 385-7405

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1548428626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 24TH AVE",
            "address_2": "SUITE 1",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594506",
            "telephone_number": "810-385-7405",
            "fax_number": "810-385-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 24TH AVE",
            "address_2": "SUITE 1",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594506",
            "telephone_number": "810-385-7405",
            "fax_number": "810-385-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNGER PHYSICAL THERAPY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "MUNGER",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/ ADMINISTRATOR",
        "authorized_official_telephone_number": "810-385-7405",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501004051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUS SHIELD OF MICHIGAN",
            "identifier": "65-0-G4-1223-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munger Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.