Individual provider Active NPI

Kathleen Drescher Stephens, PT

  • Physical Therapist
  • East Lansing, MI
National Provider Identifier
1891910782
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501003275 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 400
East Lansing, MI 48823-5353
Phone
(517) 355-7648
Fax
(517) 432-1319
NPI assigned
Apr 16, 2007
Last updated
Jul 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501003275 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 400
East Lansing, MI 48823-5353

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 355-7648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130920000471 MI Practitioner - Physical Therapist in Private Practice 0042454605 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501003275MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Physical Therapy Connection, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Michigan State University CurrentSince May 3, 2013 Accepting new patients
Michigan State University CurrentSince May 3, 2013 Accepting new patients
Msu Health Care Inc. Physical Therapist CurrentSince Jul 1, 2020 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Michigan State University Current Accepting new patients
Physical Therapy Connection LLC Physical Therapist PastSince Feb 5, 2024 Accepting new patients

Locations

4660 S Hagadorn Rd
Ste 400
East Lansing, MI 48823
Phone (517) 355-7648

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

13575 S Airport Rd
Ste 105
Lansing, MI 48906
Phone (517) 668-0000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1891910782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-355-7648",
            "fax_number": "517-432-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235353",
            "telephone_number": "517-355-7648",
            "fax_number": "517-432-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KATHLEEN",
        "middle_name": "DRESCHER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.