Individual provider Active NPI

Gwen M Dani, P.T.

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1659498756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501008791 Issued in MI
Practice address
37650 Professional Center Dr
Suite 105a
Livonia, MI 48152
Phone
(734) 953-1745
Fax
(734) 953-1743
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501008791 MI Primary

Addresses

Primary practice location

37650 Professional Center Dr
Suite 105a
Livonia, MI 48152

Mailing address

872 Hartsough St
Plymouth, MI 48170-2142
Phone (734) 737-9733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041026000381 MI Practitioner - Physical Therapist in Private Practice 2062473762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Recovery Project, LLCGroup PAC ID 9739154311, 33 clinicians

Practice addresses (Care Compare)

11878 Hubbard St
Livonia, MI 48150-1733
Phone (734) 953-1745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Recovery Project, LLC Physical Therapist CurrentSince Apr 29, 2004 Accepting new patients
Fare to Freedom Past Accepting new patients

Locations

11878 Hubbard St
Livonia, MI 48150
Phone (734) 953-1745

11878 Hubbard St
Ste 100
Livonia, MI 48150
Phone (734) 743-2909

20000 Victor Pkwy
Ste 100
Livonia, MI 48152
Phone (734) 743-2909

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659498756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 HARTSOUGH ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702142",
            "telephone_number": "734-737-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 105A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANI",
        "first_name": "GWEN",
        "middle_name": "M",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.