Individual provider Active NPI

Julie Therese Munson, PT,ATC, CSCS

  • Physical Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1750510970
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004090 Issued in MI
Practice address
23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956
Phone
(586) 779-8892
Fax
(586) 779-2869
NPI assigned
Jul 9, 2009
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004090 MI Primary

Addresses

Primary practice location

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956

Mailing address

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956
Phone (586) 779-8892

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504000563 MI Practitioner - Physical Therapist in Private Practice 8325435795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David Gilboe and Associates IncGroup PAC ID 9638299589, 5 clinicians

Practice addresses (Care Compare)

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956
Phone (586) 779-8892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501004090MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David Gilboe and Associates Inc Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients
David Gilboe & Associates, Inc. PastSince Apr 1, 2022 Accepting new patients

Locations

23161 Greater Mack Ave
St Clr Shores, MI 48080
Phone (586) 779-8892

Organizations & group practices 2

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1750510970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23161 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801956",
            "telephone_number": "586-779-8892",
            "fax_number": "586-779-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23161 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801956",
            "telephone_number": "586-779-8892",
            "fax_number": "586-779-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNSON",
        "first_name": "JULIE",
        "middle_name": "THERESE",
        "credential": "PT,ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.