KSS of Shelby LLC
Organization Active NPI Physical Therapy Clinic/Center · Shelby Township, MI
NPI 1770788739 · NPPES record last updated Jan 31, 2023
Key facts
- NPI
- 1770788739
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- KSS OF SHELBY LLC
- Practice address
- 48875 Hayes Rd
Shelby Township, MI 48315-4405 - Phone
- (586) 532-9602
- NPI assigned
- Jun 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Julie Martel
- Title
- Owner
- Phone
- (248) 601-9207
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 1
Practitioners 45
-
Alissa August, OT
-
Stephen Charron, DPT
-
Tiffani Cooper, DPT
-
Todd Michael Cummings, PT OMPT
-
Holly Daywalt, DPT
-
Garrett Emerick, DPT
-
Danielle Feldkamp, DPT
-
Caitlin Marie Hall, DPT
-
Marissa J Ogboh, DPT
-
Nicole Marie Rule, DPT
-
Douglas L Schultz, MPT ATC
-
Shane Strawska, DPT
-
Grace E Wallace, DPT
-
Tonya L Potts, DPT
-
Heather Asti, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080625000057 | MI | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9335218619 |
Receives reassigned benefits from 44 practitioners Practice locations: Saint Clair Shores, MI; Shelby TWP, MI; Warren, MI |
| O20250528000244 | MI | DME Supplier - Independently-Practicing Occupational Therapist |
9335218619 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shelby TWP, MI |
National Provider Directory
Locations
48875 Hayes Rd
Shelby Township, MI 48315
Phone (586) 532-9602
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | MI | Yes |
Addresses
Primary practice location
48875 Hayes Rd
Shelby Township, MI 48315-4405
Mailing address
1773 Star Batt Dr
Rochester Hills, MI 48309-3708
Phone (248) 601-9207
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7180463 | Other | MI | AETNA |
| 0E02153 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
Other names
- HEALTHQUEST PHYSICAL THERAPY & WELLNESS
Other providers in Shelby Township, MI
- Kroger Co of Michigan
- Kroger Co of Michigan
- Kroger Co of Michigan
- Virginia Krolczyk
- Shelley Kruszewski
- Adelynn Kuligowski
- Kenneth J Kulik
- Tina Kunarski
- Mary Jo Kurily
- Olivia Kush
All providers in Shelby Township, MI · Physical Therapy Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.