PHOENIX PHYSICAL THERAPY INC (NPI# 1326603036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326603036 |
| Entity Type | Organization |
| Organization Name | PHOENIX PHYSICAL THERAPY INC |
| Practice Address |
45628 Van Dyke Ave Utica MI 48317-5366 |
| Practice Telephone | 5867264900 |
| Mailing Telephone | 5867264900 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | EDUARDO JACOBS (CEO) |
| Authorized Official Telephone | 5865574441 |
| Authorized Official Credential | RESIDENT AGENT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LARA | 802299670 | 01 |
| Street Address |
45628 VAN DYKE AVE |
| City | UTICA |
| State | MI |
| Zip Code | 48317-5366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730403981 | Vamsi Krishna Panati | Physical Therapist | 45628 Van Dyke Ave, Utica, MI 48317-5366 | 2010-03-17 |
| 1689231532 | Continuous Transportation | Driver | 45628 Van Dyke Ave, Utica, MI 48317-5366 | 2019-05-28 |
| 1275805376 | Utica Physical Therapy Inc | Physical Therapist | 45628 Van Dyke Ave, Utica, MI 48317-5366 | 2012-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329686 | Jasmine Withers | Driver | 45835 Brownell St, Apt 9, Utica, MI 48317 | 2020-03-02 |
| 1942851670 | Kn Mental Health Services LLC | Social Worker | 1111 Hall Road, Utica, MI 48317 | 2019-09-24 |
| 1710461421 | Pureland Physical Therapy | Physical Medicine & Rehabilitation | 45555 Mound Rd, Shelby Twp, MI 48317 | 2018-09-18 |
| 1417433566 | Stephanie Marie Renner | Occupational Therapist | Regency At Shelby, 7401 22 Mile Road, Shelby Charter Township, MI 48317 | 2018-07-12 |
| 1437645959 | Jonathan G Deck | Physician Assistant | 46961 Vandyke Ave, Sheby Township, MI 48317 | 2018-07-09 |
| 1013407261 | Meredith Ann Schramski | Physician Assistant | 46961 Van Dyke Ave, Shelby Township, MI 48317 | 2018-05-14 |
| 1114446184 | Patrick Michael Roberts | Physician Assistant | 50149 Hedgeway Dr, Shelby Twp, MI 48317 | 2017-09-11 |
| 1427571702 | Boby Philip Manalel | Physical Therapist | 11150 Nature Way, Shelby Twp, MI 48317 | 2017-07-19 |
| 1285155119 | Shelby Urgent Care Walk-in Clinic | Family Medicine | 46965 Van Dyke Ave, Shelby Twp, MI 48317 | 2017-06-30 |
| 1942650718 | Samantha Parison | Technician, Other | 47980 Shelby Road, Shelby Township, MI 48317 | 2016-06-13 |
| Find all providers in zip 48317 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336507789 | Ryan Monaco Physical Therapy, Pllc | Clinic/Center | 2413 State Route 5, Utica, NY 13502-7717 | 2016-02-01 |
| 1336536671 | Roger W. Herbowy, Pt | Clinic/Center | 2516 Genesee St, Utica, NY 13502-5814 | 2015-04-24 |
| 1043603483 | Borja Physical Therapy | Clinic/Center | 8243 Hall Rd, Suite 201, Utica, MI 48317-5504 | 2015-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679485 | Thrive Physical Therapy | Clinic/Center | 835 Mason St Ste A245, Dearborn, MI 48124-2231 | 2020-11-06 |
| 1700484482 | Redford Physical Therapy LLC | Clinic/Center | 25136 W 6 Mile Rd, Redford, MI 48240-2102 | 2020-10-14 |
| 1740894500 | Sara Sue Laisure | Clinic/Center | 1105 E 8th St, Traverse City, MI 49686-2936 | 2020-08-31 |
| 1578176269 | Pro-line Physical Therapy, LLC | Clinic/Center | 25899 W 12 Mile Rd Ste 335, Southfield, MI 48034-8343 | 2020-08-24 |
| 1326650011 | Physical Therapy Center for Sports and Performing Arts, Pllc | Clinic/Center | 30475 Stephenson Hwy, Madison Heights, MI 48071-1615 | 2020-08-23 |
| 1770194607 | Restorative Rehabilitation Inc | Clinic/Center | 9228 Pelham Rd, Taylor, MI 48180-3832 | 2020-08-13 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1114537719 | Axpert Rehab Care, LLC | Clinic/Center | 22830 Kelly Rd, Eastpointe, MI 48021-2072 | 2020-08-07 |
| 1619586898 | Right Health, PC | Clinic/Center | 28345 Beck Rd Ste 412, Wixom, MI 48393-4745 | 2020-07-23 |
| 1497378368 | Launch Pediatric Rehab | Clinic/Center | 13448 Greenbriar Dr, Grand Haven, MI 49417-9161 | 2020-05-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.