Individual provider Active NPI

Roger Charles Edwards, MSPT

  • Physical Therapist
  • Northville, MI
National Provider Identifier
1740321611
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017546 Issued in MI
Practice address
215 E Main St Ste B
Northville, MI 48167-1681
Phone
(248) 349-9339
NPI assigned
Feb 12, 2007
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070013463 IL
Physical Therapist 225100000X 5501017546 MI Primary

Addresses

Primary practice location

215 E Main St Ste B
Northville, MI 48167-1681

Mailing address

996 Elmsmere Dr
Northville, MI 48167-1065
Phone (305) 926-7233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414002153 MI Practitioner - Physical Therapist in Private Practice 0143486803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070013463ILMDPhysical Therapist
5501017546MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Northville Physical Rehabilitation, P.C. Physical Therapist CurrentSince Nov 14, 2025 Accepting new patients

Locations

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

1801 W Maumee St
Ste 125
Adrian, MI 49221
Phone (517) 264-6141

2570 Jackson Ave
Ste C
Ann Arbor, MI 48103
Phone (734) 823-7820

1940 S Telegraph Rd
Bloomfield Hills, MI 48302
Phone (248) 409-0490

3050 Union Lake Rd
Ste 3C
Commerce Township, MI 48382
Phone (248) 363-8267

1485 N Michigan Ave
Ste 100
Howell, MI 48843
Phone (517) 545-5880

215 E Main St
Ste B
Northville, MI 48167
Phone (248) 349-9339

43443 Grand River Ave
Ste 200
Novi, MI 48375
Phone (248) 305-9200

Interoperability endpoints

  • Direct secure messaging: roger.edwards.p4@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1740321611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 ELMSMERE DR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671065",
            "telephone_number": "305-926-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E MAIN ST STE B",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671681",
            "telephone_number": "248-349-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROGER",
        "middle_name": "CHARLES",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013463",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.