Michelle Lynn Brock, M.P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501005109 Issued in MI

Practice address

20952 E 12 Mile Rd Ste 110
Saint Clair Shores, MI 48081-3202

Phone

(586) 498-3500

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Michelle Lynn Doan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801923479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39831 SYLVIA ST",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480451541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 110",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813202",
            "telephone_number": "586-498-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501005109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DOAN",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "M.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bridge of Hope Family Support LLC
• Bright Side Dental-St. Clair Shores PLLC
• Nancy Brigulio, LPC
• Brock Home Care Services LLC
• Allayah Brock
• Mira J Brooks, AU.D. CCC-A
• Mahogany Brown
• Jasmine Browning
• William Brownscombe
• Tiffany Ann Bruckner, D.O.

• Orthopedic Physical Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Orthopedic Physical Therapist in Michigan

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