Teagan R Pool

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

138 W Highland Rd
Howell, MI 48843-2168

Phone

(517) 376-4831

Fax

(517) 376-4833

NPI assigned

Mar 26, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Ivyrehab Northern PT, LLC

  • Behavior Analyst
  • Howell, MI
  • NPI 1770113680
  NPD
• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1972130045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432168",
            "telephone_number": "517-376-4831",
            "fax_number": "517-376-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432168",
            "telephone_number": "517-376-4831",
            "fax_number": "517-376-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOL",
        "first_name": "TEAGAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teagan.pool@ivyrehab.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "138 W Highland Rd",
            "city": "Howell",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488432168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jaime Sue Podina, MA, LLPC
• Kathy Ann Polansky-Dettling, MA, LLP
• Steven Kyle Polasek, D.D.S.
• Gregory Poma, DC
• Nicole Ponkey, OTRL
• Karly McKenzie Poole, LLMSW
• Mary Elizabeth Pope, RBT
• Michael Leland Pope
• Demi Breanna Porter Garza Pena
• Brooklyn Paige Porter

• All providers in Howell, MI
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.