DR. MICHAEL THOMAS PRUDHOMME (NPI# 1548564255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548564255 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL THOMAS PRUDHOMME |
| Credential | D.P.T. |
| Practice Address |
13638 Sibley Rd Riverview MI 48193-7406 |
| Practice Telephone | 7342883739 |
| Practice Fax Number | 7342883745 |
| Mailing Telephone | 7342883739 |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2014-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
5501010391 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM PIN | OH28738 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942365549 | Michael B Prudhomme | General Practice | Group Aid Station Mcas Yuma, Yuma, AZ 85369 | 2006-12-26 |
| 1275584732 | Michael Thomas Prudhomme | Dentist | 5760 Clarkston Rd., Suite A, Clarkston, MI 48348-4706 | 2006-05-12 |
| Street Address |
13638 SIBLEY RD |
| City | RIVERVIEW |
| State | MI |
| Zip Code | 48193-7406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659446359 | Rehab Connection Inc | Physical Therapist | 13638 Sibley Rd, Riverview, MI 48193-7406 | 2006-11-21 |
| 1770010324 | Eric B Noble | Physical Therapist | 13638 Sibley Rd, Riverview, MI 48193-7406 | 2017-05-15 |
| 1174915144 | Brian Simon | Physical Therapy Assistant | 13638 Sibley Rd, Riverview, MI 48193-7406 | 2015-02-26 |
| 1467858365 | Shannon Lucas | Physical Therapist | 13638 Sibley Rd, Riverview, MI 48193-7406 | 2014-11-05 |
| 1861527772 | Kevin C Begeman | Physical Therapist | 13638 Sibley Rd, Riverview, MI 48193-7406 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093214173 | Sana Nasir Inc. | Skilled Nursing Facility | 13840 King Rd, Riverview, MI 48193 | 2018-02-05 |
| 1710348974 | Roberta Ryan | Licensed Practical Nurse | 19048 Stonewood, Riverview, MI 48193 | 2016-03-16 |
| 1083978126 | Waqar Ahmed Yazdani | Physical Therapist | 21708 Adams Dr, Brownstown, MI 48193 | 2012-07-03 |
| 1568745008 | Adrianne Rockin Co LLC | Registered Nurse | 17735 Fort St, Riverview, MI 48193 | 2011-09-21 |
| 1962504399 | Barbara Lynn Novak | Technician/Technologist | 19216 Fort Street, Riverview, MI 48193 | 2006-09-05 |
| 1750494282 | Cosmetic Dermatology and Vein Centers of Downriver PC | Dermatology | 17171 Fort St, Riverview, MI 48193 | 2006-08-17 |
| 1235106915 | Syed Muhammad Raza | Internal Medicine | 18025 Fort St, Riverview, MI 48193 | 2006-03-02 |
| 1083686380 | John A Santoro | Dentist | 14525 Sibley Rd, Riverview, MI 48193 | 2006-02-02 |
| 1649240177 | Asker Asmi | Internal Medicine | 18025 Fort Street, Riverview, MI 48193 | 2006-01-26 |
| 1720562051 | Sana Health Inc | Skilled Nursing Facility | 13840 King Rd, Riverview, MI 48193 | 2018-09-21 |
| Find all providers in zip 48193 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972720340 | Elizabeth J Kuba | Physical Therapist | 13015 Summerfield Square Dr, Riverview, FL 33578-7402 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851514 | Rebecca Marie Beery | Physical Therapist | 9551 Saline Waterworks Rd, Manchester, MI 48158-9728 | 2020-11-05 |
| 1861037921 | Jackson Hanks II | Physical Therapist | 2901 Commerce Xing, Commerce Township, MI 48390-3084 | 2019-11-13 |
| 1366084030 | Shelby Gusfa | Physical Therapist | 36622 Five Mile Rd Ste 102, Livonia, MI 48154-1900 | 2019-10-14 |
| 1881168078 | Jessie Lynn Lewis | Physical Therapist | 3315 E Michigan Ave Ste 4, Lansing, MI 48912-4649 | 2019-01-22 |
| 1063980373 | Fuel Physical Therapy & Sports Performance, LLC | Physical Therapist | 1139 Houseman Ave Ne, Grand Rapids, MI 49503-1229 | 2018-11-05 |
| 1386111243 | Your Alternative Pt, LLC | Physical Therapist | 640 Romence Rd Ste 111, Portage, MI 49024-3400 | 2018-10-30 |
| 1811472319 | Rachel E Michalski | Physical Therapist | 12150 30 Mile Rd Ste 102, Washington Township, MI 48095-2035 | 2018-10-01 |
| 1265916852 | Kelly Gotberg | Physical Therapist | 854 Washington Ave Ste 200, Holland, MI 49423-7143 | 2018-09-19 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1790272078 | Susan G Gall | Physical Therapist | 67267 S Main St, Richmond, MI 48062-1919 | 2018-04-22 |
| 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.