Audrey Imbur, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501007223 Issued in MI

Practice address

4111 S. Canton Center Rd
Canton, MI 48188

Phone

(734) 397-0496

Fax

(734) 397-1349

NPI assigned

Feb 27, 2018

Last updated

Feb 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oakwood Healthcare Inc

  dba Corewell Health Retail Pharmacy Westland

  • Community/Retail Pharmacy
  • Westland, MI
  • NPI 1033128178
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1720589427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 S CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 S. CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48188",
            "telephone_number": "734-397-0496",
            "fax_number": "734-397-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBUR",
        "first_name": "AUDREY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iha Health Services Corporation (IHA Cherry Hill Village Primary Care)
• Iha Health Services Corporation (IHA Pediatric Healthcare-Canton)
• Iha Health Services Corporation (IHA Canton Pediatrics - Heritage Park)
• Iha of Ann Arbor PC
• Eldie Mangubat Ilano, P.T.
• Individualized Physical Therapy & Rehab P.C.
• Jeana Leigh Infantino, OTR/L
• Infinity Primary Care, PLLC
• Infinity Specialty Pharmacy LLC
• Megan Marie Inglese, FNP

• Physical Therapist in Canton, MI
• Providers in Canton, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.