Lake Orion Center for Pelvic Rehabilitation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LAKE ORION CENTER FOR PELVIC REHABILITATION

Practice address

4405 S Baldwin Rd Ste E
Lake Orion, MI 48359-2164

Phone

(248) 972-5088

Fax

(888) 521-1825

NPI assigned

Sep 24, 2020

Last updated

Jan 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kristie M Wilson, MPTNPI 1376716639

Title

Physical Therapist, Clinic Owner

Phone

(248) 972-5088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

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.

• Kristie Mae Wilson, PT

  • Physical Therapist
  • Lake Orion, MI
  • NPI 1376716639
  Medicare reassignment NPD Authorized official
• Sameena Kulsum Syed, PT

  • Physical Therapist
  • Lake Orion, MI
  • NPI 1215128947
  Medicare reassignment NPD
• Sarah Levitt

  • Physical Therapist
  • Davison, MI
  • NPI 1336688910
  Medicare reassignment

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1942817853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 S BALDWIN RD STE E",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483592164",
            "telephone_number": "248-972-5088",
            "fax_number": "888-521-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 S BALDWIN RD STE E",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483592164",
            "telephone_number": "248-972-5088",
            "fax_number": "888-521-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ORION CENTER FOR PELVIC REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, CLINIC OWNER",
        "authorized_official_telephone_number": "248-972-5088",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Rae Kryla
• Kulsum Pelvic Rehab Services
• Teresa Marie-Gennive Kwapisz
• Kyla Nutrition & Wellness
• Melissa Mary Laing, RN
• Lake Orion Chiropractic, PC
• Lake Orion Family Dentistry
• Lake Orion Nursing Center Corporation
• Lake Orion Vision PC
• Sarah-Jayne Lamb, FNP-BC

• Physical Therapist in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.