NPIMap

Organization Active NPI

Maverick Consulting LLC

  • Physical Therapy Clinic/Center
  • Traverse City, MI
National Provider Identifier
1972864585
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5201004034 Issued in MI
Legal business name
MAVERICK CONSULTING LLC
Practice address
633 W South Airport Rd # B
Traverse City, MI 49686
Phone
(231) 633-6988
Fax
(231) 421-5916
NPI assigned
May 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Deanna Sinclair, MHS, OTR/LNPI 1760740740
Title
Owner
Phone
(231) 633-6988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 5201004034 MI Primary

Addresses

Primary practice location

633 W South Airport Rd # B
Traverse City, MI 49686

Mailing address

633 W South Airport Rd # B
Traverse City, MI 49686
Phone (231) 633-6988

National Provider Directory

National Provider Directory

Locations

335 W South Airport Rd
Ste B
Traverse City, MI 49686
Phone (231) 633-6988

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1972864585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 W SOUTH AIRPORT RD # B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-633-6988",
            "fax_number": "231-421-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 W SOUTH AIRPORT RD # B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-633-6988",
            "fax_number": "231-421-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-633-6988",
        "authorized_official_credential": "MHS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5201004034",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 31, 2012; 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.