Physical Therapy One, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008230 Issued in MI

Legal business name

PHYSICAL THERAPY ONE, P.C.

Practice address

1423 W Centre Ave
Portage, MI 49024-5351

Phone

(269) 323-4300

Fax

(269) 323-4449

NPI assigned

Oct 5, 2005

Last updated

Jun 28, 2012By 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

Mr. Joseph Bruce Walters, M.S, P.TNPI 1710003157

Title

Owner, Physical Therapist

Phone

(269) 323-4300

Specialties & licenses 13

Addresses

Other identifiers 3

Locations

Practitioners 30

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.

• Joseph Bruce Walters, M.S. P.T

  • Orthopedic Physical Therapist
  • Portage, MI
  • NPI 1710003157
  NPD Authorized official
• Leah Welch Walters, P.T

  • Physical Therapist
  • Portage, MI
  • NPI 1780700112
  NPD
• Maegan Claray Ackerman-Millikan, DPT

  • Physical Therapist
  • Vicksburg, MI
  • NPI 1538939517
  NPD (past)
• Marissa Barry

  • Physical Therapy Assistant
  • Portage, MI
  • NPI 1114847696
  NPD (past)
• Peregrine Joseph Burke-McAllister, PTA

  • Physical Therapy Assistant
  • Portage, MI
  • NPI 1518573518
  NPD (past)
• Megan Laura Cooper, P.T., D.P.T

  • Physical Therapist
  • Portage, MI
  • NPI 1063796480
  NPD (past)
• Chassity Dickert

  • Physical Therapy Assistant
  • Vicksburg, MI
  • NPI 1578013355
  NPD (past)
• Cristi Dodge Julien, DPT

  • Physical Therapist
  • Portage, MI
  • NPI 1679906739
  NPD (past)
• Marilyn Grace Finstrom, DPT

  • Physical Therapist
  • Portage, MI
  • NPI 1982493441
  NPD (past)
• Mary-Teresa Geralyn Fletter, M.S.P.T.

  • Physical Therapist
  • Portage, MI
  • NPI 1689791014
  NPD (past)
• Jordan Henning

  • Physical Therapist
  • Portage, MI
  • NPI 1407404957
  NPD (past)
• Lindsay Noelle Henning, PT

  • Physical Therapist
  • Portage, MI
  • NPI 1396286183
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1962499855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245351",
            "telephone_number": "269-323-4300",
            "fax_number": "269-323-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245351",
            "telephone_number": "269-323-4300",
            "fax_number": "269-323-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ONE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "269-323-4300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S, P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008230",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008430",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011392",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011041",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004752",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009829",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010759",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013485",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012189",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015684",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013900",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502000788",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002365",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P93923",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30702",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBA/PHP",
            "identifier": "64-32017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lloyd D. Peterson, BCBA-D
• Scott M Peterson, MD
• Phadia US Inc. (Phadia Immunology Reference Lab)
• Emma Phelps
• Grace Phelps, LLC
• Physiotherapy Associates Inc
• Carly Piacentini, MS, BCBA
• Kathleen Piecuch, LPC
• Scott Piereson
• David Scott Pierrard

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.