Active NPI
Dennis Daclison
- Physical Therapist
- Harper Woods, MI
National Provider Identifier
1881764371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501006639
- Practice address
- 20225 Danbury LN
Harper Woods, MI 48225-1156 - Phone
- (313) 884-8920
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501006639 | MI | Primary |
Addresses
Primary practice location
20225 Danbury LN
Harper Woods, MI 48225-1156
Mailing address
6077 Big Rock Dr
Grand Blanc, MI 48439-7993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501006639 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kovacek Peterson Management LLC | Physical Therapist | Past | Accepting new patients |
| In Home Rehab,LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Roseville, MI
- NPI 1942248422
-
- Physical Therapist
- Frankenmuth, MI
- NPI 1598771339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881764371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6077 BIG ROCK DR",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484397993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20225 DANBURY LN",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251156",
"telephone_number": "313-884-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DACLISON",
"first_name": "DENNIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501006639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harper Woods, MI
Sources for this page
- 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.