Individual provider Active NPI

Ranu Jain

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1205087632
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013464 Issued in MI
Practice address
1960 28TH St SE
Suite B
Grand Rapids, MI 49508-7900
Phone
(616) 475-9888
NPI assigned
Oct 3, 2008
Last updated
Jan 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501013464 MI Primary
Physical Therapist 225100000X 070.016453 IL
Physical Therapist 225100000X 05009550A IN

Addresses

Primary practice location

1960 28TH St SE
Suite B
Grand Rapids, MI 49508-7900

Mailing address

1212 E Whiting St
#502
Tampa, FL 33602-4106
Phone (940) 447-1601

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.016453ILMDPhysical Therapist
05009550AINMDPhysical Therapist
5501013464MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation, Inc. CurrentSince May 30, 2025 Accepting new patients

Locations

13801 Bruce B Downs Blvd
Ste 303
Tampa, FL 33613
Phone (813) 979-4819

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1205087632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 E WHITING ST",
            "address_2": "#502",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024106",
            "telephone_number": "940-447-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 28TH ST SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087900",
            "telephone_number": "616-475-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RANU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013464",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.016453",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009550A",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.