Individual provider Active NPI

Stephen Charron, DPT

  • Physical Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1922877604
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501303155 Issued in MI
Practice address
20229 E 9 Mile Rd Ste 240
Saint Clair Shores, MI 48080-1775
Phone
(586) 265-5252
NPI assigned
Dec 22, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KSS of Shelby LLC 23 clinicians

Practice addresses (Care Compare)

20229 E 9 Mile Rd
Suite 240
Saint Clair Shores, MI 48080-1775
Phone (586) 265-5252

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20240111004394 MI Practitioner - Physical Therapist in Private Practice 4587015755 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501303155MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HQ of Chesterfield LLC Physical Therapist CurrentSince Mar 8, 2024 Accepting new patients
KSS of Shelby LLC CurrentSince Dec 20, 2023 Accepting new patients
CKS of Mt Clemens LLC Physical Therapist CurrentSince Mar 8, 2024 Accepting new patients
KSS of Shelby LLC Physical Therapist CurrentSince Dec 20, 2023 Accepting new patients

Locations

32155 23 Mile Rd
Chesterfield, MI 48047
Phone (248) 788-6100

21550 Harrington St
Ste D
Clinton Twp, MI 48036
Phone (586) 783-7590

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

20229 E 9 Mile Rd
#240
Saint Clair Shores, MI 48080
Phone (586) 265-5252

48875 Hayes Rd
Shelby Township, MI 48315
Phone (586) 532-9602

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501303155 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

20229 E 9 Mile Rd Ste 240
Saint Clair Shores, MI 48080-1775

Mailing address

1773 Star Batt Dr
Rochester Hills, MI 48309-3708
Phone (248) 601-9207

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 22, 2023.

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1922877604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093708",
            "telephone_number": "248-601-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20229 E 9 MILE RD STE 240",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-265-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARRON",
        "first_name": "STEPHEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303155",
            "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 Dec 22, 2023; 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.