NPIMap

Organization Active NPI

Trumbull & Associates Physical Therapy & Spine PLLC

  • Physical Therapy Clinic/Center
  • Grand Haven, MI
National Provider Identifier
1104352087
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TRUMBULL & ASSOCIATES PHYSICAL THERAPY & SPINE PLLC
Practice address
950 Taylor Ave
Suite 180
Grand Haven, MI 49417-2282
Phone
(616) 200-4428
Fax
(616) 200-4436
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Authorized official

Name
Dr. Tom Kenneth Trumbull IV, DPTNPI 1528394079
Title
Owner
Phone
(616) 200-4428

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

950 Taylor Ave
Suite 180
Grand Haven, MI 49417-2282

Mailing address

950 Taylor Ave
Suite 180
Grand Haven, MI 49417-2282
Phone (616) 200-4428

Other names 1

  • Resolve Grand Haven Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901000061 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8224301882 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Haven, MI

National Provider Directory

National Provider Directory

Locations

950 Taylor Ave
Ste 180
Grand Haven, MI 49417
Phone (616) 200-4428

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1104352087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 TAYLOR AVE",
            "address_2": "SUITE 180",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172282",
            "telephone_number": "616-200-4428",
            "fax_number": "616-200-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 TAYLOR AVE",
            "address_2": "SUITE 180",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172282",
            "telephone_number": "616-200-4428",
            "fax_number": "616-200-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUMBULL & ASSOCIATES PHYSICAL THERAPY & SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "TRUMBULL",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-200-4428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resolve Grand Haven Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Resolve Grand Haven Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.