Individual provider Active NPI

Mackenzie Harris, DPT

  • Physical Therapist
  • Holland, MI
National Provider Identifier
1083368286
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501301897 Issued in MI
Practice address
854 Washington Ave
Holland, MI 49423-7144
Phone
(616) 392-9430
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 5501301897 MI Primary

Addresses

Primary practice location

854 Washington Ave
Holland, MI 49423-7144

Mailing address

365 84TH St SW
Byron Center, MI 49315-7935

Other practice location 1

1787 Grand Ridge Ct NE Ste 103
Grand Rapids, MI 49525-7042
Phone (616) 410-7370

Other practice location 2

365 84th St SW
Byron Center, MI 49315-7935
Phone (616) 277-1768

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220404001243 MI Practitioner - Physical Therapist in Private Practice 2668868449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501301897MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Assoicates, Inc. CurrentSince Dec 14, 2025 Accepting new patients
Physiotherapy Associates, Inc CurrentSince Feb 1, 2022 Accepting new patients
Physiotherapy Associates, Inc. Physical Therapist Current Accepting new patients
Physiotherapy Associates Inc CurrentSince Feb 1, 2022 Accepting new patients

Locations

365 84th St SW
Byron Center, MI 49315
Phone (616) 277-1768

1787 Grand Ridge Ct NE
Ste 103
Grand Rapids, MI 49525
Phone (616) 363-7690

11561 Edgerton Ave NE
Rockford, MI 49341
Phone (616) 866-2727

Organizations & group practices 4

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1083368286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 84TH ST SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237144",
            "telephone_number": "616-392-9430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1787 Grand Ridge Ct NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495257042",
            "country_code": "US",
            "telephone_number": "616-410-7370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "365 84th St SW",
            "address_purpose": "LOCATION",
            "city": "Byron Center",
            "state": "MI",
            "postal_code": "493157935",
            "country_code": "US",
            "telephone_number": "616-277-1768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MACKENZIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501301897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.