Active NPI
Alicia Adams
- Geriatric Physical Therapist
- Caledonia, MI
National Provider Identifier
1184196792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- Practice address
- 1690 Sweet Grass Dr SE
Caledonia, MI 49316-7309 - Phone
- (616) 485-7587
- NPI assigned
- Dec 20, 2018
- Last updated
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | Primary |
Addresses
Primary practice location
1690 Sweet Grass Dr SE
Caledonia, MI 49316-7309
Mailing address
2100 Raybrook St SE Ste 300
Grand Rapids, MI 49546-5783
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501016773 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1184196792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 RAYBROOK ST SE STE 300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495465783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1690 SWEET GRASS DR SE",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493167309",
"telephone_number": "616-485-7587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-20",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5501016773",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Caledonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.