Grand River Rehabilitation LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301091218 Issued in MI

Legal business name

GRAND RIVER REHABILITATION LLC

Practice address

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028

Phone

(616) 780-2324

Fax

(877) 991-4975

NPI assigned

May 19, 2018

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Adam Joseph Rush, MDNPI 1528095643

Title

Owner

Phone

(616) 780-7389

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20015/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adam Joseph Rush, MD

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
  • NPI 1528095643

  Pediatrics

  Medicare reassignment Care Compare group NPD Authorized official
• Courtney Lee Hersha, FNP-C

  • Family Nurse Practitioner
  • Portage, MI
  • NPI 1386521623
  Medicare reassignment Care Compare group NPD
• Lisa Marie Voss, DO

  • Pediatric Rehabilitation Medicine Physician
  • Grand Rapids, MI
  • NPI 1760702609

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1124519707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-2324",
            "fax_number": "877-991-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-780-2324",
            "fax_number": "877-991-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIVER REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-19",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-780-7389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301091218",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301091218",
            "primary": true
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MI",
            "license": "4301091218",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ENUMERATOR",
            "identifier": "1528095643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand River Cardiology, PLC
• Grand River Emergency Medical Group PLC
• Grand River Endoscopy Center, L.L.C.
• Grand River Gastroenterology PC
• Grand River Mobility LLC (Next Day Access of Grand Rapids and Lansing)
• Grand Valley Dental Care, P.C.
• Grand Valley Family Health Center
• Grand Valley Gynecologists, P.C.
• Grand Valley Medical Specialists PLC
• Grand Valley State University

• Physical Medicine & Rehabilitation Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.