NPIMap

Organization Active NPI

Movement Orthopedics

  • Orthopaedic Surgery Physician
  • Clinton Township, MI
National Provider Identifier
1912365032
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MOVEMENT ORTHOPEDICS
Practice address
43475 Dalcoma Dr
Suite #160
Clinton Township, MI 48038-3591
Phone
(586) 436-3785
NPI assigned
Feb 3, 2016
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Dr. Jeffrey John Carroll, D.O.NPI 1255360897
Title
President
Phone
(586) 436-3785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Non-Pharmacy Dispensing Site 332900000X NU

Addresses

Primary practice location

43475 Dalcoma Dr
Suite #160
Clinton Township, MI 48038-3591

Mailing address

43475 Dalcoma Dr
Suite #160
Clinton Township, MI 48038-3591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160526001123 MI Part B Supplier - Clinic/Group Practice 8022308477 Receives reassigned benefits from 7 practitioners
Practice locations: Clinton Township, MI; Lenox, MI
O20180504000741 MI DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8022308477 Practice locations: Clinton Township, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2326718Movement Orthopedics43475 Dalcoma Drive Suite 250, Clinton Township, MI 48038Certificate of waiverJul 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Movement Orthopedics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

43475 Dalcoma Dr
Ste 160
Clinton Twp, MI 48038
Phone (248) 221-1845

Practitioners & affiliated clinicians

Practitioners 8

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": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1912365032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR",
            "address_2": "SUITE #160",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR",
            "address_2": "SUITE #160",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383591",
            "telephone_number": "586-436-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOVEMENT ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2024-07-09",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-436-3785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.