Individual provider Active NPI

Erika Marie Cooley, DPT

  • Orthopedic Physical Therapist
  • Kentwood, MI
National Provider Identifier
1063229896
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501302704 Issued in MI
Practice address
1423 60TH St SE
Kentwood, MI 49508-7065
Phone
(616) 455-3535
NPI assigned
Dec 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5501302704 MI Primary

Addresses

Primary practice location

1423 60TH St SE
Kentwood, MI 49508-7065

Mailing address

4951 Oakway CT NE
Grand Rapids, MI 49525-6836
Phone (303) 324-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219000314 MI Practitioner - Physical Therapist in Private Practice 6608396833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentwood Physical Therapy, PLLCGroup PAC ID 0446341671, 4 clinicians

Practice addresses (Care Compare)

1423 60TH St SE
Kentwood, MI 49508-7065
Phone (616) 455-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501302704MIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentwood Physical Therapy, PLLC Orthopedic CurrentSince Jan 2, 2025 Accepting new patients

Locations

1423 60th St SE
Kentwood, MI 49508
Phone (616) 446-9058

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1063229896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 OAKWAY CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256836",
            "telephone_number": "303-324-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 60TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087065",
            "telephone_number": "616-455-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "ERIKA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501302704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.