Jacklyn Coppola, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017144 Issued in MI

Practice address

47284 Michigan Ave
Canton, MI 48188-2582

Phone

(734) 418-5237

NPI assigned

Jan 18, 2016

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacklyn Charzynski Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Benchmark Physical Therapy Michigan LLC

  • Physical Therapist
  • Midland, MI
  • NPI 1629740188
  Medicare reassignment NPD
• Michigan Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Ann Arbor, MI
  • NPI 1003448994
  Medicare reassignment NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Bloomfield Hills, MI
  • NPI 1548932619
  Medicare reassignment NPD
• Benchmark Physical Therapy Michigan LLC

  • Physical Therapist
  • Canton, MI
  • NPI 1336950492
  NPD
• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Marietta, GA
  • NPI 1508538158
  NPD

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1942667290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-497-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47284 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882582",
            "telephone_number": "734-418-5237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1693 N Canton Center Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481872948",
            "country_code": "US",
            "telephone_number": "734-738-0000",
            "fax_number": "734-738-0038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17500 Federal Dr Ste 750",
            "address_purpose": "LOCATION",
            "city": "Allen Park",
            "state": "MI",
            "postal_code": "481013656",
            "country_code": "US",
            "telephone_number": "313-982-1370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "JACKLYN",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLYN",
            "last_name": "CHARZYNSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Contemporary Dentistry Center Canton PLLC
• Contemporary Dentistry Center PLLC
• Raymond Cook
• Erin Coomer
• Michael William Copi, PHARMD
• Crystal Cordes
• Corecare Solutions Home Health Services LLC (CoreCare Solutions)
• Lydia Maria Cornejo
• Cornerstone Case Management & Consulting, L.L.C.
• Cornerstone Home Health

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.