Individual provider Active NPI

Kathleen Ann Jensen

  • Physical Therapist
  • Canton, MI
National Provider Identifier
1679925986
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302335 Issued in MI
Practice address
5969 N Canton Center Rd
Canton, MI 48187-2757
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502003562 MI
Physical Therapist 225100000X 5501302335 MI Primary

Addresses

Primary practice location

5969 N Canton Center Rd
Canton, MI 48187-2757

Mailing address

209 S Cherry St
Flushing, MI 48433-2020
Phone (810) 487-9733

Other practice location 1

1220 N LeRoy St
Fenton, MI 48430-2760
Phone (810) 487-9733

Other practice location 2

209 S Cherry St
Flushing, MI 48433-2020
Phone (810) 487-9733

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services MI LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129002962 MI Practitioner - Physical Therapist in Private Practice 9234504838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Mi LLCGroup PAC ID 2769819960, 84 clinicians

Practice addresses (Care Compare)

5969 N Canton Ctr Rd
Canton, MI 48187-2757
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5502003562MIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Mi LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Dearborn Speech and Sensory Center, Inc Physical Therapist CurrentSince Jan 10, 2026 Accepting new patients

Locations

219 N Main St
Davison, MI 48423
Phone (810) 412-4573

44670 Ann Arbor Rd W
Ste 130
Plymouth, MI 48170
Phone (424) 295-8088

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1679925986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S CHERRY ST",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332020",
            "telephone_number": "810-487-9733",
            "fax_number": "810-867-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5969 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872757",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 N LeRoy St",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484302760",
            "country_code": "US",
            "telephone_number": "810-487-9733",
            "fax_number": "810-867-4938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "209 S Cherry St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "MI",
            "postal_code": "484332020",
            "country_code": "US",
            "telephone_number": "810-487-9733",
            "fax_number": "810-867-4938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003562",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services MI LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "5969 N Canton Center Rd",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481872757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.