Organization Active NPI

Energy Physical Therapy and Rehabilitation LLC

  • Orthopedic Physical Therapist
  • Warren, MI
National Provider Identifier
1811409436
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
ENERGY PHYSICAL THERAPY AND REHABILITATION LLC
Practice address
27789 Mound Rd
Warren, MI 48092-2697
Phone
(586) 261-8013
Fax
(586) 580-9448
NPI assigned
Nov 5, 2017
Last updated
Feb 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Authorized official

Name
Dr. Sam Hakki, MD
Title
Chairman
Phone
(727) 422-4688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

27789 Mound Rd
Warren, MI 48092-2697

Mailing address

PO Box 880
Sterling Heights, MI 48311-0880
Phone (727) 422-4688

Other names 1

  • ENERGY PT Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190820000655 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365770088 Practice locations: Warren, MI

National Provider Directory

National Provider Directory

Locations

27789 Mound Rd
Ste 300
Warren, MI 48092
Phone (586) 203-9888

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1811409436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483110880",
            "telephone_number": "727-422-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27789 MOUND RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922697",
            "telephone_number": "586-261-8013",
            "fax_number": "586-580-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGY PHYSICAL THERAPY AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-05",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "HAKKI",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "727-422-4688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENERGY PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.