NPIMap

Organization Active NPI

Associated Orthopedist of Detroit

  • Physical Therapy Assistant
  • Saint Clair Shores, MI
National Provider Identifier
1902165566
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502000482 Issued in MI
Legal business name
ASSOCIATED ORTHOPEDIST OF DETROIT
Practice address
24715 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-3207
Phone
(586) 779-7970
Fax
(586) 779-7748
NPI assigned
May 16, 2012
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Jamie Johnson
Title
Credentialing Manager
Phone
(586) 710-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502000482 MI Primary

Addresses

Primary practice location

24715 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-3207

Mailing address

24715 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-3207
Phone (586) 779-7970

National Provider Directory

National Provider Directory
Tax ID family
Associated Orthopedist of Detroit4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1902165566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970",
            "fax_number": "586-779-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970",
            "fax_number": "586-779-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED ORTHOPEDIST OF DETROIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "586-710-2307"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502000482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.