Ivyrehab Michigan, LLC
NPI 1104337120 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Fenton, MI
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ivyrehab Michigan, LLC is a Sports Medicine (Physical Medicine & Rehabilitation) Physician organization in Fenton, MI (NPI 1104337120).
Provider details
- NPI number
- 1104337120
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ashley Griffiths, Sr. Director of Provider Relations(914) 294-4050
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-10-17
- Last updated
- 2025-09-16
- Certified
- 2025-09-16
Frequently asked questions
- What is Ivyrehab Michigan, LLC's NPI number?
- Ivyrehab Michigan, LLC's National Provider Identifier (NPI) is 1104337120, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ivyrehab Michigan, LLC?
- Ivyrehab Michigan, LLC is classified in the NPPES registry as Sports Medicine (Physical Medicine & Rehabilitation) Physician (Allopathic & Osteopathic Physicians).
- Where is Ivyrehab Michigan, LLC located?
- Ivyrehab Michigan, LLC's practice location on file with NPPES is 400 Rounds Dr, Fenton, MI 48430-1724.
- What is Ivyrehab Michigan, LLC's phone number?
- The practice phone number listed in the NPPES registry for Ivyrehab Michigan, LLC is (810) 750-1996.
- Does Ivyrehab Michigan, LLC accept Medicare?
- Ivyrehab Michigan, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ivyrehab Michigan, LLC?
- The authorized official listed on Ivyrehab Michigan, LLC's NPPES record is Ashley Griffiths, Sr. Director of Provider Relations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ivyrehab Michigan, LLC's NPI active?
- Yes — Ivyrehab Michigan, LLC's NPI (1104337120) is active in the NPPES registry as of the last update on 2025-09-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.