William Shriver

Key facts

NPI

1972373728

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

5501303168 (MI)

Practice address

1928 Star Batt Dr
Rochester Hills, MI 48309-3722

Phone

(248) 289-1169

NPI assigned

Jan 3, 2024

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

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.

• Clint Verran Sports Medicine, Inc Physical Therapist · Lake Orion, MI · NPI 1013033604
  Medicare reassignment Care Compare group NPD MI · PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clint Verran Sports Medicine, Inc (3 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 3, 2024.

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1972373728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 BOLINGER ST",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093722",
            "telephone_number": "248-289-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Rochester Hills, MI · Physical Therapist in Michigan