Jennifer Kornowski, M.S.P.T., M.D.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501009512 Issued in MI

Practice address

3282 Clear Vista CT NE
Suite a
Grand Rapids, MI 49525-9477

Phone

(616) 365-2709

Fax

(616) 365-3174

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hulst Jepsen Physical Therapy IncGroup PAC ID 8325033285, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hulst Jepsen Physical Therapy Inc

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1609957760
  Medicare reassignment Care Compare group NPD
• Hulst Jepsen Physical Therapy Inc

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1396969754
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205901121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 43RD ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495083772",
            "telephone_number": "616-281-1144",
            "fax_number": "616-281-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3282 CLEAR VISTA CT NE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259477",
            "telephone_number": "616-365-2709",
            "fax_number": "616-365-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNOWSKI",
        "first_name": "JENNIFER",
        "credential": "M.S.P.T., M.D.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Kornoelje, DPT
• Edwin T Kornoelje, D.O.
• Robb Kornoelje, LPC
• Joshua Kornoely, ATC
• Stephen Kornoely, LMSW
• Marissa Korodan
• Tara Lynn Koronkiewicz, OTR/L
• Edward Korot, M.D.
• Noelle Korpusik
• Lauren Evelyn Korson, NP

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.