Mary Ellen Gough, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501002209 Issued in MI

Practice address

42536 Hayes Rd Ste 100
Clinton Township, MI 48038-3644

Phone

(586) 286-9644

Fax

(586) 286-9647

NPI assigned

Jan 29, 2009

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

• Mary Ellen Mischel Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Quality Care Rehabilitation Professionals

  • Occupational Therapist
  • Shelby Township, MI
  • NPI 1437718830
  NPD (past)
• Quality Care Rehabilitation Professionals, Inc

  • Specialist
  • Shelby Township, MI
  • NPI 1396817771

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1881832822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40644 SAINT LOUIS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480387129",
            "telephone_number": "586-416-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42536 HAYES RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383644",
            "telephone_number": "586-286-9644",
            "fax_number": "586-286-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501002209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MISCHEL",
            "middle_name": "ELLEN",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madeline Gordon
• Miranda Gorges
• Donna Lynn Gorman, OT
• Christopher F Gortat, RPH
• Gunateet K Goswami, MD
• Philesha Gough
• Trista Gould, LLMSW
• Demetrius Govan
• Kathleen Lillian Graca
• Grace 21 Hospice Agency LLC

• Physical Therapist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.