Gina E Houtteman, PT, MSPT
Individual provider Active NPI Physical Therapist · Whitehall, MI
NPI 1023643285 · NPPES record last updated Mar 9, 2020
Key facts
- NPI
- 1023643285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501010194 (MI)
- Practice address
- 541 E Slocum St
Whitehall, MI 49461-1199 - Phone
- (318) 931-0772
- Fax
- (616) 847-1290
- NPI assigned
- Mar 9, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shoreline Sport and Spine PLLC
Practice addresses (Care Compare)
18000 Cove St
Spring Lake, MI 49456-1383
Phone (616) 847-1280
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200527002815 | MI | Practitioner - Physical Therapist in Private Practice | 1658792759 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010194 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoreline Sport & Spine PLLC | Physical Therapist | Current |
Accepting new patients |
| Shoreline Sport & Spine PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
18000 Cove St
Ste 202
Spring Lake, MI 49456
Phone (616) 847-1280
541 E Slocum St
Whitehall, MI 49461
Phone (318) 931-0772
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010194 | MI | Yes |
Addresses
Primary practice location
541 E Slocum St
Whitehall, MI 49461-1199
Mailing address
18000 Cove St Ste 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280
Other providers in Whitehall, MI
- Hackley Hospital
- Hackley Professional Pharmacy
- Isabel Susan Marie Hammond
- Eric Charles Haynes
- Heartland of Whitehall Mi LLC
- HPCN
- HPCN
- Wayne Stewart Jackson
- Kima Johnson
- Kelly'S Kare Afc
All providers in Whitehall, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.