Larry S Phipps, BS, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

23662

Practice address

30901 Palmer Rd
Westland, MI 48186-9529

Phone

(734) 367-8477

Fax

(734) 722-9524

NPI assigned

Aug 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1790977593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20018 CENTRALIA",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401103",
            "telephone_number": "313-532-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30901 PALMER RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481869529",
            "telephone_number": "734-367-8477",
            "fax_number": "734-722-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "LARRY",
        "middle_name": "S",
        "credential": "BS, CTRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": "23662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "23662",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WRPH",
            "identifier": "1508883299",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kim Pianko
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• Recreation Therapist in Westland, MI
• Providers in Westland, MI by specialty
• Recreation Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.