Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum
Health Source Physical Therapy Center, Inc.
Physical Therapy Clinic/Center in Portland, MI · enumerated 2006 · authorized official Jaya Boddu, President.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1083624969
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Registry record
Taxonomy & classification
Authorized official
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30472 | Other | MI | BCN |
| P109760 | Other | MI | BCN |
| 64-00030 | Other | MI | PHP |
| 650C457010 | Other | MI | BCBS |
| 10-4266217 | Medicaid | MI | - |
| 5501005495 | Other | MI | PRIORITY HEALTH |
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.
Frequently asked questions
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Providers at this address
Browse all →Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-12-20.