Jeremy William Hagadorn, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501020172 Issued in MI

Practice address

133 W Main St Ste 120
Northville, MI 48167-1548

Phone

(248) 347-1168

Fax

(248) 347-1252

NPI assigned

Aug 27, 2019

Last updated

Aug 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plymouth Physical Therapy Specialists Limited PartnershipGroup PAC ID 3870488521, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Northville, MI
  • NPI 1174626329
  Medicare reassignment Care Compare group NPD
• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Jackson, MI
  • NPI 1740733419
  NPD (past)
• Coppola Physical Therapy Ferry

  • Physical Therapist
  • Concord, NH
  • NPI 1982988192
  NPD (past)

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1932757622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9368 N LILLEY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704610",
            "telephone_number": "248-347-1168",
            "fax_number": "248-347-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MAIN ST STE 120",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671548",
            "telephone_number": "248-347-1168",
            "fax_number": "248-347-1252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Ferry St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033015022",
            "country_code": "US",
            "telephone_number": "603-715-9697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381584",
            "country_code": "US",
            "telephone_number": "603-918-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGADORN",
        "first_name": "JEREMY",
        "middle_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501020172",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Gust, PH.D.
• Arika Gustafson
• Samantha Ashlee Guyah, MSW
• Mary Haddad
• Jessie A Hadley
• Emily Hahn
• Sarah Haidar Ahmad
• Sanar Haji, LMSW
• Bashar Hamad, RBT
• Nabil Hamati, DPM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.