Organization Active NPI

Bio Balance Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Farmington Hills, MI
National Provider Identifier
1568066371
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BIO BALANCE PHYSICAL THERAPY PC
Practice address
23023 Orchard Lake Rd Ste C
Farmington Hills, MI 48336-3267
Phone
(248) 345-3117
Fax
(248) 471-0838
NPI assigned
Nov 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Leslie Chudnow
Title
Billing Manager
Phone
(248) 855-1875

Specialties & licenses 1

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

Addresses

Primary practice location

23023 Orchard Lake Rd Ste C
Farmington Hills, MI 48336-3267

Mailing address

22521 Glenmoor HTS
Farmington Hills, MI 48336-3523
Phone (248) 345-3117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201228001815 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668885278 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1568066371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22521 GLENMOOR HTS",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483363523",
            "telephone_number": "248-345-3117",
            "fax_number": "248-471-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23023 ORCHARD LAKE RD STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483363267",
            "telephone_number": "248-345-3117",
            "fax_number": "248-471-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIO BALANCE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "CHUDNOW",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "248-855-1875"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.