NPIMap

Organization Active NPI

Dynamic Physical Therapy Inc

  • Physical Therapist
  • Cadillac, MI
National Provider Identifier
1609874288
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DYNAMIC PHYSICAL THERAPY INC
Practice address
8872 Professional Dr
Suite C
Cadillac, MI 49601-8481
Phone
(231) 876-0010
Fax
(231) 876-1246
NPI assigned
Jul 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Mr. Roger KarstenNPI 1215152764
Title
President
Phone
(231) 876-0010

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 TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

8872 Professional Dr
Suite C
Cadillac, MI 49601-8481

Mailing address

8872 Professional Dr
Suite C
Cadillac, MI 49601-8481
Phone (231) 876-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061025000725 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628986643 Receives reassigned benefits from 13 practitioners
Practice locations: Traverse City, MI; Marion, MI; Manistee, MI; Ludington, MI; Cadillac, MI; Gaylord, MI; Buckley, MI

National Provider Directory

National Provider Directory

Locations

11293 N M 37
Ste B
Buckley, MI 49620
Phone (231) 269-3500

8872 Professional Dr
Ste C
Cadillac, MI 49601
Phone (231) 876-0010

2147 Professional Dr
Ste 2
Gaylord, MI 49735
Phone (989) 732-0001

1107 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-3027

1806 E Parkdale Ave
Ste 2
Manistee, MI 49660
Phone (231) 723-5479

1363 Douglas Dr
Ste 104
Traverse City, MI 49696
Phone (231) 272-2472

1721 S Garfield Ave
Traverse City, MI 49686

1721 S Garfield Ave
Ste 2
Traverse City, MI 49686
Phone (231) 876-0010

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1609874288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8872 PROFESSIONAL DR",
            "address_2": "SUITE C",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018481",
            "telephone_number": "231-876-0010",
            "fax_number": "231-876-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8872 PROFESSIONAL DR",
            "address_2": "SUITE C",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018481",
            "telephone_number": "231-876-0010",
            "fax_number": "231-876-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "KARSTEN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-876-0010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.