Organization Active NPI

Physical Therapy at Home, PLLC

  • Physical Therapist
  • Shelby Township, MI
National Provider Identifier
1972721058
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501003709 Issued in MI
Legal business name
PHYSICAL THERAPY AT HOME, PLLC
Practice address
55808 Nickelby S
Shelby Township, MI 48316-1008
Phone
(248) 933-8250
Fax
(248) 650-0556
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Mrs. Jennifer Lynn Hildreth, P.T.
Title
Owner
Phone
(248) 933-8250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5501003709 MI Primary

Addresses

Primary practice location

55808 Nickelby S
Shelby Township, MI 48316-1008

Mailing address

55808 Nickelby S
Shelby Township, MI 48316-1008
Phone (248) 933-8250

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1972721058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55808 NICKELBY S",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161008",
            "telephone_number": "248-933-8250",
            "fax_number": "248-650-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55808 NICKELBY S",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161008",
            "telephone_number": "248-933-8250",
            "fax_number": "248-650-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AT HOME, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-933-8250",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.