Dynamic Edge Rehab Services LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

DYNAMIC EDGE REHAB SERVICES LLC

Practice address

11363 San Elia Dr
Sterling Heights, MI 48312-1276

Phone

(248) 312-9052

NPI assigned

Oct 1, 2024

Last updated

Oct 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Chintan R Shah, DPTNPI 1962644617

Title

Director of Rehab

Phone

(248) 312-9052

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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.

• Chintan Shah, RPT

  • Physical Therapist
  • Sterling Heights, MI
  • NPI 1962644617
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1699593426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11363 SAN ELIA DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11363 SAN ELIA DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121276",
            "telephone_number": "248-312-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC EDGE REHAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "CHINTAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "248-312-9052",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Durocher
• Bennett Francis Dwan, MD
• Lillman Dwarka, MD
• Dymphna Counselling
• Dynaflex Home Health Care, LLC
• Dynamic Healthcare PLLC
• Dynamic Management Group, LLC (Dynamic Healthcare)
• Dynasty Rehabilitation Services PC
• Sierra Estelle Dynkowski
• Ruzica Dzebo, M.D.

• Physical Therapy Clinic/Center in Sterling Heights, MI
• Providers in Sterling Heights, 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 Oct 1, 2024; 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.