Stephen Ray Gillhespy

Individual provider Active NPI Physical Therapist · Sparta, MI

NPI 1083562532 · NPPES record last updated Mar 19, 2026

Key facts

NPI
1083562532
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501019357 (MI)
Practice address
31 Ida Red Ave
Sparta, MI 49345-1277
Phone
(616) 887-8152
NPI assigned
Mar 19, 2026
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Boston, MA 02241

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260328000336 MI Practitioner - Physical Therapist in Private Practice 8628553500 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501019357MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Physical Therapy PC Physical Therapist Past Accepting new patients
Ivyrehab Northern PT, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019357 MI Yes

Addresses

Primary practice location

31 Ida Red Ave
Sparta, MI 49345-1277

Mailing address

31 Ida Red Ave
Sparta, MI 49345-1277
Phone (616) 887-8152

Other providers in Sparta, MI

All providers in Sparta, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.