Organization Active NPI

Movement Physical Therapy LLC

  • Physical Therapist
  • Clinton TWP, MI
National Provider Identifier
1942797683
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOVEMENT PHYSICAL THERAPY LLC
Practice address
43475 Dalcoma
Suite 140
Clinton TWP, MI 48038-3550
Phone
(586) 488-2440
Fax
(586) 488-2441
NPI assigned
Apr 18, 2018
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Dr. Jeffrey Carroll, D.O.NPI 1255360897
Title
Owner
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

43475 Dalcoma
Suite 140
Clinton TWP, MI 48038-3550

Mailing address

33900 Harper Ave
Suite 104
Clinton TWP, MI 48035
Phone (586) 350-2065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180503001613 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426312174 Receives reassigned benefits from 3 practitioners
Practice locations: Clinton TWP, MI

National Provider Directory

National Provider Directory

Locations

43475 Dalcoma Dr
Ste 250
Clinton Twp, MI 48038
Phone (586) 436-3785

Practitioners & affiliated clinicians

Practitioners 4

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": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1942797683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "48035",
            "telephone_number": "586-350-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA",
            "address_2": "SUITE 140",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383550",
            "telephone_number": "586-488-2440",
            "fax_number": "586-488-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOVEMENT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-436-3785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.