NPIMap

Organization Active NPI

Associted Orthopedist of Detroti

  • Physical Therapy Assistant
  • Shelby TWP, MI
National Provider Identifier
1689932980
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
55020000231 Issued in MI
Legal business name
ASSOCITED ORTHOPEDIST OF DETROTI
Practice address
50505 Schoenherr
Suite 140
Shelby TWP, MI 48301
Phone
(586) 710-2320
Fax
(586) 997-9298
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Jamie Johnson
Title
Credentialing Manager
Phone
(586) 710-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 55020000231 MI Primary

Addresses

Primary practice location

50505 Schoenherr
Suite 140
Shelby TWP, MI 48301

Mailing address

24715 Little Mack Ave Ste 100
Saint Clair Shores, MI 48080-3207
Phone (586) 779-7970

National Provider Directory

National Provider Directory
Tax ID family
Associated Ortho4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24715 Little Mack Ave
Ste 100
St Clr Shores, MI 48080
Phone (586) 779-2585

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1689932980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE STE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970",
            "fax_number": "586-779-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR",
            "address_2": "SUITE 140",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "586-710-2320",
            "fax_number": "586-997-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCITED ORTHOPEDIST OF DETROTI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "586-710-2307"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "55020000231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.