Individual provider Active NPI

Jamie Hebner, PT

  • Physical Therapist
  • Jenison, MI
National Provider Identifier
1184995177
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011245 Issued in MI
Practice address
1915 Georgetown Center Dr Ste 102
Jenison, MI 49428-7121
Phone
(616) 356-5000
Fax
(616) 356-5001
NPI assigned
Jan 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 5501011245 MI Primary

Addresses

Primary practice location

1915 Georgetown Center Dr Ste 102
Jenison, MI 49428-7121

Mailing address

607 Dewey Ave NW Ste 300
Grand Rapids, MI 49504-7335
Phone (616) 356-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511001433 MI Practitioner - Physical Therapist in Private Practice 2264841808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

1915 Georgetown Ctr Dr
Suite 102
Jenison, MI 49428-7121
Phone (616) 233-5483

2373 64TH St SW
Suite 2100
Byron Center, MI 49315-7976
Phone (616) 235-3970

3686 32ND Ave
Suite 400
Hudsonville, MI 49426-8546
Phone (616) 377-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Alliance Physical Therapy Group LLC Physical Therapist CurrentSince Mar 15, 2021 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients

Locations

6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014

2373 64th St SW
Ste 2100
Byron Center, MI 49315
Phone (616) 235-3970

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

1915 Georgetown Center Dr
Ste 102
Jenison, MI 49428
Phone (616) 233-5483

5886 Venture Park Dr
Kalamazoo, MI 49009
Phone (269) 375-4737

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.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1184995177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 GEORGETOWN CENTER DR STE 102",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287121",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBNER",
        "first_name": "JAMIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.