NPIMap

Organization Active NPI

NLJ Physical Therapy Center P.C.

  • Physical Medicine & Rehabilitation Physician
  • Kingsford, MI
National Provider Identifier
1902814312
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5501003258 Issued in MI
Legal business name
NLJ PHYSICAL THERAPY CENTER P.C.
Practice address
901 Pyle Drive
Kingsford, MI 49802-4452
Phone
(906) 774-3779
Fax
(906) 774-6712
NPI assigned
Aug 3, 2006
Last updated
Mar 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Mr. Neal Lorn Johnson, LICENSED PHYSICAL THNPI 1457386716
Title
Owner President of Clinic
Phone
(906) 774-3779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4326024 WI
Physical Medicine & Rehabilitation Physician 208100000X 5501003258 MI Primary

Addresses

Primary practice location

901 Pyle Drive
Kingsford, MI 49802-4452

Mailing address

901 Pyle Drive
Kingsford, MI 49802-4452
Phone (906) 774-3779

Other identifiers 4

IdentifierTypeStateIssuer
650012048OtherRAILROAD MEDICARE
380747012OtherTRICARE NORTH
1009687OtherPREFERRED ONE
650B257010OtherBCBS OF MICH

National Provider Directory

National Provider Directory

Locations

901 Pyle Dr
Kingsford, MI 49802
Phone (906) 774-3779

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1902814312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PYLE DRIVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024452",
            "telephone_number": "906-774-3779",
            "fax_number": "906-774-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PYLE DRIVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024452",
            "telephone_number": "906-774-3779",
            "fax_number": "906-774-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NLJ PHYSICAL THERAPY CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "LORN",
        "authorized_official_title_or_position": "OWNER PRESIDENT OF CLINIC",
        "authorized_official_telephone_number": "906-774-3779",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSED PHYSICAL TH"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "4326024",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501003258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650012048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH",
            "identifier": "380747012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1009687",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICH",
            "identifier": "650B257010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.