SPORTS MEDICINE CENTER OF METRO DETROIT PC (NPI# 1912023458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912023458 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE CENTER OF METRO DETROIT PC |
| Practice Address |
5600 Crooks Rd Suite 103 Troy MI 48098-2811 |
| Practice Telephone | 2488130002 |
| Practice Fax Number | 2488130007 |
| Mailing Telephone | 2488130002 |
| Mailing Fax Number | 2488130007 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | MISS JACKIE TREMONTI (BILLER) |
| Authorized Official Telephone | 2488130002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | JC039731 | MI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1741033 | 05 |
| Street Address |
5600 CROOKS RD SUITE 103 |
| City | TROY |
| State | MI |
| Zip Code | 48098-2811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720061187 | Jerome V Ciullo | Orthopaedic Surgery | 5600 Crooks Rd, Ste 103, Troy, MI 48098-2811 | 2005-11-21 |
| 1871709691 | Rehabilitation Specialists Top of Troy PC | Physical Therapist | 5600 Crooks Rd, Suite 104, Troy, MI 48098-2811 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053949289 | Douglas Ross | Physical Therapy Assistant | 4062 Livernois Rd, Troy, MI 48098 | 2020-04-01 |
| 1104382837 | Minxes Inc | Chiropractor | 1175 W. Long Lake Rd, Suite 100, Troy, MI 48098 | 2019-02-19 |
| 1689160053 | Nyssa J Swanson | Physical Therapist | 5440 Corporate Dr Ste 400, Troy, MI 48098 | 2018-07-09 |
| 1447742580 | Rebecca Jane Stros | Counselor | 900 Tower Dr, Troy, MI 48098 | 2018-06-05 |
| 1356863278 | Brigette Johnson | Occupational Therapist | 4794 Riverchase Dr, Troy, MI 48098 | 2017-07-12 |
| 1912448382 | Devyn Depeter | Technician/Technologist | 5877 Livernois Rd Ste 104, Troy, MI 48098 | 2017-03-17 |
| 1285025015 | Rochester Knee & Sports Medicine PC | Durable Medical Equipment & Medical Supplies | 4600 Investment Dr Ste 120, Troy, MI 48098 | 2015-02-16 |
| 1649690231 | Tammy Beesley-schick | Registered Nurse | 4568 Odette Ct, Troy, MI 48098 | 2014-04-22 |
| 1306269584 | Medi-care | Ambulance | 5741 Faircastle, Troy, MI 48098 | 2014-01-24 |
| 1881953644 | Diane Marie Bald | Social Worker | 1707 White Birch Ct, Troy, MI 48098 | 2012-05-14 |
| Find all providers in zip 48098 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669957510 | Deandra Perez | Specialist | 16 Blakley Ct Fl 1, Troy, NY 12180-5820 | 2018-09-26 |
| 1538677588 | Peak Neurophysiology Group, LLC | Specialist | 13 Stoneledge Dr Apt 11, Troy, NY 12182-3519 | 2018-01-11 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1891230454 | Pure Healthy Back | Specialist | 1500 W Big Beaver Rd Ste 150, Troy, MI 48084-3552 | 2017-01-05 |
| 1831563527 | Sabrina L Pennington | Specialist | 104 Emily Ct, Troy, AL 36079-2981 | 2015-11-18 |
| 1992100358 | Catherine Rinella | Specialist | 1098 Spring Avenue Ext, Troy, NY 12180-7313 | 2014-10-28 |
| 1518383256 | Jennifer Bobersky | Specialist | 3 Patricia Dr, Troy, NY 12180-6132 | 2014-03-05 |
| 1699103796 | Helen Rezey | Specialist | 6 Greene St, Troy, NY 12180-6720 | 2013-10-29 |
| 1346591641 | Robin Jean Kennedy | Specialist | 597 Third Ave., Troy, NY 12182 | 2012-09-26 |
| 1770834210 | Andrew Mcnally | Specialist | 3226 Veterans Stadium Dr, Troy, AL 36082-0001 | 2012-09-24 |
| Find all providers in TROY | ||||
Please comment or provide details below to improve the information on SPORTS MEDICINE CENTER OF METRO DETROIT PC.
| 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.