Individual provider Active NPI

Jennifer Elizabeth Powers, DPT

  • Physical Therapist
  • Holt, MI
National Provider Identifier
1063997476
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302603 Issued in MI
Practice address
2380 Cedar St Ste 203
Holt, MI 48842-2211
Phone
(517) 709-4677
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physical Therapist 225100000X 5501302603 MI Primary

Addresses

Primary practice location

2380 Cedar St Ste 203
Holt, MI 48842-2211

Mailing address

2380 Cedar St Ste 203
Holt, MI 48842-2211
Phone (517) 709-4677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801002710 MI Practitioner - Physical Therapist in Private Practice 0840651295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northwestern College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier RehabilitationGroup PAC ID 5698094795, 19 clinicians

Practice addresses (Care Compare)

2380 Cedar St
Suite 203
Holt, MI 48842-2211
Phone (517) 709-4677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Rehabilitation Physical Therapist CurrentSince Jul 5, 2023 Accepting new patients

Locations

2380 Cedar St
Ste 203
Holt, MI 48842
Phone (517) 709-4677

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1063997476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST STE 203",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422211",
            "telephone_number": "517-709-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST STE 203",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422211",
            "telephone_number": "517-709-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.