Individual provider Active NPI

Christine Veenstra

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1194484618
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
721 3 Mile Rd NW Ste 100
Grand Rapids, MI 49544-8230
Phone
(616) 265-2414
NPI assigned
Dec 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 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 Primary

Addresses

Primary practice location

721 3 Mile Rd NW Ste 100
Grand Rapids, MI 49544-8230

Mailing address

PO Box 30516
Dept 5300
Lansing, MI 48909-8016

Other identifiers 1

IdentifierTypeStateIssuer
5501011697OtherMISTATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220119002651 MI Practitioner - Physical Therapist in Private Practice 4284026428 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hulst Jepsen Physical Therapy Inc Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients

Locations

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

721 3 Mile Rd NW
Ste 100
Walker, MI 49544
Phone (616) 608-8933

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": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1194484618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 5300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 3 MILE RD NW STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448230",
            "telephone_number": "616-265-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEENSTRA",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "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",
            "identifier": "5501011697",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.