Seven Stars Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SEVEN STARS PHYSICAL THERAPY LLC

Practice address

26105 W 6 Mile Rd
Redford, MI 48240-2218

Phone

(313) 377-8737

NPI assigned

Oct 8, 2021

Last updated

Oct 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jalal Baydoun

Title

Owner

Phone

(313) 377-8737

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shreepal Chanduri, PT

  • Physical Therapist
  • Pontiac, MI
  • NPI 1295985141
  Medicare reassignment NPD

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1902568884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26105 W 6 MILE RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482402218",
            "telephone_number": "313-377-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26105 W 6 MILE RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482402218",
            "telephone_number": "313-377-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVEN STARS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "BAYDOUN",
        "authorized_official_first_name": "JALAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-377-8737"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OTHER",
            "affiliation": "N",
            "endpointDescription": "OTHER",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "26105 W 6 Mile Rd",
            "city": "Redford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482402218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Akash Shah, PT
• Kelly Susewitz Shakoor, FNP-BC
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• Tiffani Shebli
• Susan Shelley

• Physical Therapist in Redford, MI
• Providers in Redford, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.