Individual provider Active NPI

Jennifer M Grelewicz, PT, MSPT

  • Physical Therapist
  • Spring Lake, MI
National Provider Identifier
1063470490
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501012441 Issued in MI
Practice address
18000 Cove St
Suite 202
Spring Lake, MI 49456-1299
Phone
(616) 847-1280
Fax
(616) 847-1290
NPI assigned
May 3, 2006
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501012441 MI Primary

Addresses

Primary practice location

18000 Cove St
Suite 202
Spring Lake, MI 49456-1299

Mailing address

18000 Cove St
Suite 202
Spring Lake, MI 49456-1299
Phone (616) 847-1280

Other names 1

  • Jennifer M McCann, McCann-Bauer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000500 MI Practitioner - Physical Therapist in Private Practice 7113942491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Sport and Spine PLLCGroup PAC ID 4284673575, 44 clinicians

Practice addresses (Care Compare)

18000 Cove St
Suite 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Sport & Spine PLLC Physical Therapist CurrentSince Oct 3, 2016 Accepting new patients
Shoreline Sport & Spine PLLC Physical Therapist CurrentSince Oct 3, 2016 Accepting new patients

Locations

18000 Cove St
Ste 202
Spring Lake, MI 49456
Phone (616) 847-1280

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1063470490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 COVE ST",
            "address_2": "SUITE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561299",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 COVE ST",
            "address_2": "SUITE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561299",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRELEWICZ",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCCANN, MCCANN-BAUER",
            "middle_name": "M",
            "credential": "PT, MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.