Active NPI
John Gregory Phillippo, RPT
- Physical Therapist
- Traverse City, MI
National Provider Identifier
1972793958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501000866
- Practice address
- 325 W 8TH St
Traverse City, MI 49684-3103 - Phone
- (231) 633-8011
- Fax
- (231) 995-0921
- NPI assigned
- Jul 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501000866 | MI | Primary |
Addresses
Primary practice location
325 W 8TH St
Traverse City, MI 49684-3103
Mailing address
PO Box 6742
Traverse City, MI 49696-6742
Phone (231) 633-8011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OB85703 | Other | MI | BLUE CROSS BLUE SHIELD OF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerated Mobility Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Traverse City, MI
- NPI 1295887594
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492992000000",
"number": "1972793958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6742",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496966742",
"telephone_number": "231-633-8011",
"fax_number": "231-995-0921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W 8TH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496843103",
"telephone_number": "231-633-8011",
"fax_number": "231-995-0921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPPO",
"first_name": "JOHN",
"middle_name": "GREGORY",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-26",
"last_updated": "2017-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501000866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF",
"identifier": "OB85703",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.