Organization Active NPI

Omni Kinetics

  • Physical Therapy Clinic/Center
  • Plymouth, MI
National Provider Identifier
1760828131
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OMNI KINETICS
Practice address
8768 N Territorial Rd
C/O Fox Hills
Plymouth, MI 48170-5022
Phone
(248) 229-8628
NPI assigned
May 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Mr. Graham A Polakoff, MS, ATC
Title
Owner Operator
Phone
(248) 229-8628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

8768 N Territorial Rd
C/O Fox Hills
Plymouth, MI 48170-5022

Mailing address

3602 Normandy Rd
Royal Oak, MI 48073-1651
Phone (248) 229-8628

National Provider Directory

National Provider Directory

Locations

1025 Webster St
Birmingham, MI 48009
Phone (248) 399-8880

8768 N Territorial Rd
Plymouth, MI 48170
Phone (248) 229-8628

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1760828131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 NORMANDY RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731651",
            "telephone_number": "248-229-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8768 N TERRITORIAL RD",
            "address_2": "C/O FOX HILLS",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481705022",
            "telephone_number": "248-229-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI KINETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "POLAKOFF",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "248-229-8628",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.