Active NPI
West Michigan Rehabilitation Center, Inc
- Physical Therapist
- Grandville, MI
National Provider Identifier
1023072550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501005841
- Legal business name
- WEST MICHIGAN REHABILITATION CENTER, INC
- Practice address
- 3181 Prairie St SW
Suite 102
Grandville, MI 49418-2097 - Phone
- (616) 249-3545
- Fax
- (616) 249-3549
- NPI assigned
- Apr 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Pasupathy Vadivelu I, BACHOLOR DEGREE
- Title
- Administrator
- Phone
- (616) 249-3545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501005841 | MI | Primary |
Addresses
Primary practice location
3181 Prairie St SW
Suite 102
Grandville, MI 49418-2097
Mailing address
3181 Prairie St SW
Suite 102
Grandville, MI 49418-2097
Phone (616) 249-3545
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1023072550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 PRAIRIE ST SW",
"address_2": "SUITE 102",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182097",
"telephone_number": "616-249-3545",
"fax_number": "616-249-3549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 PRAIRIE ST SW",
"address_2": "SUITE 102",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182097",
"telephone_number": "616-249-3545",
"fax_number": "616-249-3549"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST MICHIGAN REHABILITATION CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VADIVELU",
"authorized_official_first_name": "PASUPATHY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "616-249-3545",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "I",
"authorized_official_credential": "BACHOLOR DEGREE"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501005841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grandville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.