Active NPI
Leslie Givens, PT
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1013386077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501017410
- Practice address
- 4085 Burton St SE Ste 100
Grand Rapids, MI 49546-2444 - Phone
- (616) 233-3599
- Fax
- (616) 285-6030
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1316376 | TX | |
| Physical Therapist | 225100000X | 5501017410 | MI | Primary |
Addresses
Primary practice location
4085 Burton St SE Ste 100
Grand Rapids, MI 49546-2444
Mailing address
625 Kenmoor Ave SE
Grand Rapids, MI 49546-2395
Phone (616) 483-3480
Other practice location 1
35724 Van Dyke Ave
Sterling Heights, MI 48312-3564
Phone (586) 698-0081
Other practice location 2
7411 Remcon Cir Ste A
El Paso, TX 79912-3539
Phone (915) 317-1131
Other names 1
- Mary Mayville
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1013386077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 KENMOOR AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462395",
"telephone_number": "616-483-3480",
"fax_number": "616-356-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4085 BURTON ST SE STE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462444",
"telephone_number": "616-233-3599",
"fax_number": "616-285-6030"
}
],
"practiceLocations": [
{
"address_1": "35724 Van Dyke Ave",
"address_purpose": "LOCATION",
"city": "Sterling Heights",
"state": "MI",
"postal_code": "483123564",
"country_code": "US",
"telephone_number": "586-698-0081",
"fax_number": "586-795-0885",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7411 Remcon Cir Ste A",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799123539",
"country_code": "US",
"telephone_number": "915-317-1131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIVENS",
"first_name": "LESLIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1316376",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "MAYVILLE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.