NPIMap

Organization Active NPI

Paxxon Healthcare Services LLC

  • Physical Therapist
  • Superior Township, MI
National Provider Identifier
1740840602
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PAXXON HEALTHCARE SERVICES LLC
Practice address
8100 Geddes Road
Superior Township, MI 48198
Phone
(734) 506-0630
Fax
(734) 506-0631
NPI assigned
Jun 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Authorized official

Name
Randall A Weston
Title
Ceo
Phone
(484) 239-2963

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

8100 Geddes Road
Superior Township, MI 48198

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958
Phone (610) 438-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190723000857 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8325959554 Receives reassigned benefits from 13 practitioners
Practice locations: Lake Orion, MI

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Paxxon Hlthcare SVCS LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

3451 Clarkston Rd
Lake Orion, MI 48360
Phone (734) 506-0630

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1740840602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "610-438-2020",
            "fax_number": "610-438-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 GEDDES ROAD",
            "city": "SUPERIOR TOWNSHIP",
            "state": "MI",
            "postal_code": "48198",
            "telephone_number": "734-506-0630",
            "fax_number": "734-506-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAXXON HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "WESTON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-239-2963"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.