Individual provider Active NPI

Christine Burke, DPT

  • Physical Therapist
  • Hudsonville, MI
National Provider Identifier
1104487347
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5819 Balsam Dr
Hudsonville, MI 49426-1104
Phone
(616) 209-5435
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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 Primary

Addresses

Primary practice location

5819 Balsam Dr
Hudsonville, MI 49426-1104

Mailing address

4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300
Phone (616) 608-9978

Other identifiers 1

IdentifierTypeStateIssuer
5501016004OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731003402 MI Practitioner - Physical Therapist in Private Practice 7315273182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hulst Jepsen Physical Therapy IncGroup PAC ID 8325033285, 132 clinicians

Practice addresses (Care Compare)

2120 43Rd St SE
Suite 100
Grand Rapids, MI 49508-3712
Phone (616) 281-1144

26 N State St
Zeeland, MI 49464-1281
Phone (616) 256-8677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hulst Jepsen Physical Therapy Inc Physical Therapist CurrentSince Jul 15, 2019 Accepting new patients

Locations

2120 43rd St SE
Ste 100
Grand Rapids, MI 49508
Phone (616) 281-1144

4761 Lake Michigan Dr NW
Ste A
Grand Rapids, MI 49534
Phone (616) 608-9978

5819 Balsam Dr
Hudsonville, MI 49426
Phone (616) 209-5435

26 N State St
Zeeland, MI 49464
Phone (616) 256-8677

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1104487347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4761 LAKE MICHIGAN DR NW STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346300",
            "telephone_number": "616-608-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 BALSAM DR",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261104",
            "telephone_number": "616-209-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5501016004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.