Michigan Orthopedic Rehabilitation LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MICHIGAN ORTHOPEDIC REHABILITATION LLC

Practice address

4401 W 13 Mile Rd
Royal Oak, MI 48073-6516

Phone

(248) 566-3525

Fax

(248) 566-3527

NPI assigned

Oct 18, 2012

Last updated

Feb 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark S Fuqua

Title

Owner

Phone

(248) 566-3525

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Ahern

  • Physical Therapist
  • Royal Oak, MI
  • NPI 1407790397
  Medicare reassignment NPD
• Amy Suzanne Barlage, PT

  • Pediatric Physical Therapist
  • Royal Oak, MI
  • NPI 1518785112

  Neurology

  Medicare reassignment NPD
• Christine M Buchanan, P.T.

  • Physical Therapist
  • Royal Oak, MI
  • NPI 1497951362
  Medicare reassignment NPD
• Anne Marie Chmielewski, OTR

  • Occupational Therapist
  • Troy, MI
  • NPI 1922012871
  Medicare reassignment NPD
• Lisa Deconinck, MPT

  • Physical Therapist
  • Troy, MI
  • NPI 1275681793
  Medicare reassignment NPD
• Chleo Viselle Hugo, OTRL

  • Occupational Therapist
  • Royal Oak, MI
  • NPI 1639850522
  Medicare reassignment NPD
• Austin Kneip

  • Physical Therapist
  • Berkley, MI
  • NPI 1740659671
  Medicare reassignment NPD
• Nicole Rondini Korbecki, OTR

  • Occupational Therapist
  • Commerce Township, MI
  • NPI 1497932875
  Medicare reassignment NPD
• Joshua Wenzlaff, PT, DPT, ATC

  • Physical Therapist
  • Troy, MI
  • NPI 1225427776
  Medicare reassignment NPD
• Timothy Loren Wiater, DPT

  • Physical Therapist
  • Royal Oak, MI
  • NPI 1841514437
  Medicare reassignment NPD
• Taylor Alexa Hall

  • Physical Therapist
  • Oak Park, MI
  • NPI 1487508164
  Medicare reassignment
• Alexandria Chapie

  • Physical Therapist
  • Troy, MI
  • NPI 1194317040
  NPD

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1801149695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736516",
            "telephone_number": "248-566-3525",
            "fax_number": "248-566-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736516",
            "telephone_number": "248-566-3525",
            "fax_number": "248-566-3527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6024 Livernois Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480981502",
            "country_code": "US",
            "telephone_number": "248-817-6110",
            "fax_number": "248-817-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN ORTHOPEDIC REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "FUQUA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-566-3525",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Healthcare Professionals PC (Comprehensive Medical Center)
• Michigan Open MRI LLC (Central Medical Imaging)
• Michigan Orthopaedic Physical Therapy
• Michigan Orthopaedic Spine Surgeons PC
• Michigan Orthopaedic Surgeons PLLC
• Michigan Pain Management LLC
• Michigan Podiatry Institute, P.C.
• Michigan Progressive Health
• Anne Marie Michon, NP
• Lauren Michon, PT, DPT

• Physical Therapy Clinic/Center in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.