NPIMap

Organization Active NPI

Crawl Walk Jump Run Therapy Clinic LLC

  • Physical Therapist
  • Sterling Heights, MI
National Provider Identifier
1730363573
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CRAWL WALK JUMP RUN THERAPY CLINIC LLC
Practice address
43239 Schoenherr Rd
Sterling Heights, MI 48313-1957
Phone
(586) 323-2957
Fax
(586) 323-0022
NPI assigned
Dec 27, 2007
Last updated
Feb 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Authorized official

Name
Mrs. Stephanie Serafimovski, MPTNPI 1679516140
Title
Owner
Phone
(586) 323-2957

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

43239 Schoenherr Rd
Sterling Heights, MI 48313-1957

Mailing address

43239 Schoenherr Rd
Sterling Heights, MI 48313-1957
Phone (586) 323-2957

Other identifiers 1

IdentifierTypeStateIssuer
104942376MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060619000031 MI Part B Supplier - Clinic/Group Practice 5294747002 Receives reassigned benefits from 15 practitioners
Practice locations: Clinton Township, MI

National Provider Directory

National Provider Directory

Locations

42850 Garfield Rd
Ste 103
Clinton Township, MI 48038
Phone (586) 263-0222

42804 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 323-2457

43650 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 228-2075

Practitioners & affiliated clinicians

Practitioners 69

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.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1730363573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43239 SCHOENHERR RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131957",
            "telephone_number": "586-323-2957",
            "fax_number": "586-323-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43239 SCHOENHERR RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131957",
            "telephone_number": "586-323-2957",
            "fax_number": "586-323-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWL WALK JUMP RUN THERAPY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "SERAFIMOVSKI",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-323-2957",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104942376",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.