Port Huron Therapy Center LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

PORT HURON THERAPY CENTER LLC

Practice address

34051 Gratiot Ave
Suite 103
Clinton Township, MI 48035-3592

Phone

(810) 385-9808

Fax

(586) 415-7800

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Muhammad Zafar

Title

President / Ceo

Phone

(810) 385-9808

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Midwest Therapy Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Allen Kincer

  • Physical Therapist
  • Clinton TWP, MI
  • NPI 1992905103
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1871546739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34051 GRATIOT AVE",
            "address_2": "SUITE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480353592",
            "telephone_number": "810-385-9808",
            "fax_number": "586-415-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34051 GRATIOT AVE",
            "address_2": "SUITE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480353592",
            "telephone_number": "810-385-9808",
            "fax_number": "586-415-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HURON THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "ZAFAR",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "810-385-9808",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES PPO",
            "identifier": "137801",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "5135045",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142585",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30426",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4704356",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "234528",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30322",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mike Polewski, PA
• John Polyzois, DO
• Leon Popaj, MD
• Haley Melissa Pope, DO
• Kyler James Popp, OD
• Deborah Disanto Porter, OTR/L
• Nichole Diamond Porter
• Sarah J Posson, DPT
• Karen Marie Potchynok-Lund, D.P.M.
• Cecilia Powell

• Respite Care in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Respite Care in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.