Ryan Peroceschi, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601001170 Issued in MI

Practice address

1705 Pyle Dr
Kingsford, MI 49802-1143

Phone

(906) 774-2900

Fax

(906) 774-2902

NPI assigned

Nov 28, 2023

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Back in Motion Physical Therapy Clinic, P.C.

  • Orthopedic Physical Therapist
  • Kingsford, MI
  • NPI 1871799775
  NPD

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1649046947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021143",
            "telephone_number": "906-774-2900",
            "fax_number": "906-774-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021143",
            "telephone_number": "906-774-2900",
            "fax_number": "906-774-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROCESCHI",
        "first_name": "RYAN",
        "credential": "AT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Osterberg, OTR
• Katie Lynn Ouradnik I, SST, QIDP
• Morgan Mae Owens
• Pauldinglight PC
• Jordan Pell
• Cassidy Peterson, BT
• Patti Lynn Peterson, M.D.
• Katie Ann Picucci, DO
• Rebecca Pivoris
• Christi Plautz

• Athletic Trainer in Kingsford, MI
• Providers in Kingsford, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.