Davis Vardunny, PTA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5502000088 Issued in MI

Practice address

18535 W 12 Mile Rd
Suite B
Lathrup Village, MI 48076-2676

Phone

(248) 552-3740

Fax

(248) 552-3744

NPI assigned

Nov 20, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Davin Rehab Services.Inc

  • Physical Therapist
  • Southfield, MI
  • NPI 1174720197
  NPD (past)

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1962832402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24217 GRAND TRAVERSE AVE",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481348051",
            "telephone_number": "248-552-3740",
            "fax_number": "248-552-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18535 W 12 MILE RD",
            "address_2": "SUITE B",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762676",
            "telephone_number": "248-552-3740",
            "fax_number": "248-552-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDUNNY",
        "first_name": "DAVIS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5502000088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tranquility Home Health and Respite Care
• Shealah Treece, MSW
• Trusted Family Caregivers LLC
• Bernadine Tuitt
• US Health Pharmaceuticals, LLC
• Shobhan Vyas
• Tasia West
• Whole Body Health Clinic
• Destinee Nacole Williams, MSW
• Elaine K Williams, M.S.W.

• Physical Therapy Clinic/Center in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.