Fenton Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FENTON PHYSICAL THERAPY, LLC

Doing business as

Fenton PT
Fenton Physical Therapy

Practice address

14229 Torrey Rd Ste 2
Fenton, MI 48430-3308

Phone

(810) 629-3338

NPI assigned

Aug 17, 2021

Last updated

Aug 17, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

HIRT FOOT AND ANKLE SPECIALISTS P CAs reported in NPPES

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

Authorized official

Name

Corey Otis

Title

Office Manager

Phone

(810) 629-3338

Specialties & licenses 1

Addresses

Other names 2

• Fenton PT Doing business as
• Fenton Physical Therapy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Hirt Foot Ankle Specialists

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Hirt Foot and Ankle Specialists P C

  dba Brighton Family Foot Care

  • Customized Equipment (DME)
  • Fenton, MI
  • NPI 1871047779

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Alexander Holdren, DPT

  • Physical Therapist
  • Fenton, MI
  • NPI 1689140071
  Medicare reassignment NPD

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1669148029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14229 TORREY RD STE 1",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303308",
            "telephone_number": "810-629-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14229 TORREY RD STE 2",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303308",
            "telephone_number": "810-629-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIRT FOOT AND ANKLE SPECIALISTS P C",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "OTIS",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-629-3338"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fentonpt.com",
            "affiliation": "N",
            "address_1": "14229 Torrey Rd Ste 2",
            "city": "Fenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484303308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fenton PT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fenton Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fenton Medical Center
• Fenton Pharmacy LLC (Fenton Pharmacy)
• Fenton Pharmacy LLC
• Fenton Pharmacy RX Mi LLC
• Fenton Pharmacy RX Mi LLC
• Fenton Professionals LLC
• Fenton Smiles PLLC
• Fenton Therapy Services LLC
• Fenton Vision Sensory and Learning Center PLLC
• Fenton Wellness (Jennifer Flack)

• Physical Therapy Clinic/Center in Fenton, MI
• Providers in Fenton, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.