NPIMap

Organization Active NPI

Dequindre Physical Therapy & Rehab Service Inc.

  • Specialist
  • Troy, MI
National Provider Identifier
1871675447
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DEQUINDRE PHYSICAL THERAPY & REHAB SERVICE INC.
Practice address
41069 Dequindre Road
Suite 102
Troy, MI 48085-6730
Phone
(248) 879-9400
Fax
(248) 879-2348
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Authorized official

Name
Mr. Markus M Munger, PTNPI 1225219561
Title
Owner
Phone
(248) 879-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

41069 Dequindre Road
Suite 102
Troy, MI 48085-6730

Mailing address

41069 Dequindre Road
Suite 102
Troy, MI 48085-6730
Phone (248) 879-9400

Other identifiers 1

IdentifierTypeStateIssuer
30454OtherMIBCBSM

Other names 1

  • Dequindre Physical Therapy & Rehab Service Inc. Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1871675447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41069 DEQUINDRE ROAD",
            "address_2": "SUITE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480856730",
            "telephone_number": "248-879-9400",
            "fax_number": "248-879-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41069 DEQUINDRE ROAD",
            "address_2": "SUITE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480856730",
            "telephone_number": "248-879-9400",
            "fax_number": "248-879-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEQUINDRE PHYSICAL THERAPY & REHAB SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "MUNGER",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-879-9400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "30454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dequindre Physical Therapy & Rehab Service Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.