Individual provider Active NPI

Kristina Farron

  • Physical Therapist
  • Ypsilanti, MI
National Provider Identifier
1780233049
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019268 Issued in MI
Practice address
3145 W Clark Rd Ste 102
Ypsilanti, MI 48197-1120
Phone
(734) 619-0193
NPI assigned
Sep 10, 2019
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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 5501019268 MI Primary

Addresses

Primary practice location

3145 W Clark Rd Ste 102
Ypsilanti, MI 48197-1120

Mailing address

1908 W Milham Ave
Portage, MI 49024-1232
Phone (269) 459-6212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025002703 MI Practitioner - Physical Therapist in Private Practice 4789916602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9368 N Lilley Rd
Plymouth, MI 48170-4610
Phone (734) 416-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist CurrentSince Sep 2, 2023 Accepting new patients
Hanneken Physical Therapy LLC Physical Therapist CurrentSince Oct 19, 2020 Accepting new patients

Locations

49650 Cherry Hill Rd
Ste 230
Canton, MI 48187
Phone (734) 495-3725

286 Hoover Blvd
Holland, MI 49423
Phone (616) 392-2172

4128 E Grand River Ave
Howell, MI 48843
Phone (517) 540-1060

39885 Grand River Ave
Ste 300
Novi, MI 48375
Phone (248) 615-0282

9368 N Lilley Rd
Plymouth, MI 48170
Phone (734) 416-3900

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1780233049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 W MILHAM AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241232",
            "telephone_number": "269-459-6212",
            "fax_number": "269-585-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 W CLARK RD STE 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971120",
            "telephone_number": "734-619-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRON",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.