Active NPI
Tracy Zervos, P.T.
- Physical Therapist
- Newaygo, MI
National Provider Identifier
1609286681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501012308
- Practice address
- 1 State Rd
Newaygo, MI 49337-7981 - Phone
- (231) 355-5300
- Fax
- (231) 355-5325
- NPI assigned
- Apr 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501012308 | MI | Primary |
Addresses
Primary practice location
1 State Rd
Newaygo, MI 49337-7981
Mailing address
Visiting Nurse Assn MC 480 Spectrum Health
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (231) 355-5300
Other practice location 1
601 E Main St
Hart, MI 49420-1144
Phone (231) 873-3577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501012308 | Other | MI | PT STATE LICENSE |
Other names 1
- Tracy Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Michigan, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Fenton, MI
- NPI 1104337120
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1609286681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "VISITING NURSE ASSN MC 480 SPECTRUM HEALTH",
"address_2": "100 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "231-355-5300",
"fax_number": "231-355-5325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 STATE RD",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493377981",
"telephone_number": "231-355-5300",
"fax_number": "231-355-5325"
}
],
"practiceLocations": [
{
"address_1": "601 E Main St",
"address_purpose": "LOCATION",
"city": "Hart",
"state": "MI",
"postal_code": "494201144",
"country_code": "US",
"telephone_number": "231-873-3577",
"fax_number": "231-873-3557",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZERVOS",
"first_name": "TRACY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-30",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT STATE LICENSE",
"identifier": "5501012308",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "SMITH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Newaygo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.