Active NPI
Elyse Grant, PT, DPT
- Physical Therapist
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501303436
- Practice address
- 235 Wealthy St SE
Grand Rapids, MI 49503-5247 - Phone
- (616) 840-8000
- NPI assigned
- Oct 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT6173 | NM | |
| Physical Therapist | 225100000X | 5501303436 | MI | Primary |
Addresses
Primary practice location
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Mailing address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, MI
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501303436 | MI | MD | Physical Therapist |
| PT6173 | NM | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Free Bed Rehabilitation Hospital | Current | Accepting new patients | |
| Lovelace Unm Rehabilitation Hospital, LLC | Current | Accepting new patients | |
| Lovelace Unm Rehabilitation Hospital LLC | Current | Accepting new patients | |
| Lovelace Unm Rehabilitation Hospital LLC | Physical Therapist | Current | Accepting new patients |
| Mary Free Bed Rehabilitation Hospital | Current | Accepting new patients |
Locations
235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422
505 Elm St NE
Albuquerque, NM 87102
Phone (505) 727-4700
4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360
4250 Coors Blvd SW
Ste C
Albuquerque, NM 87121
Phone (505) 727-4725
Organizations & group practices 5
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.
-
- Rehabilitation Hospital
- Grand Rapids, MI
- NPI 1730133463
-
- Rehabilitation Hospital
- Albuquerque, NM
- NPI 1700325677
-
dba Mary Free Bed Medical Group
- Physical Medicine & Rehabilitation Physician
- Grand Rapids, MI
- NPI 1053641589
-
- Physical Therapist
- Albuquerque, NM
- NPI 1982103735
-
dba Lovelace Rehabilitation Hospital-Rio Rancho
- Clinic/Center
- Rio Rancho, NM
- NPI 1215411814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1225745292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035247",
"telephone_number": "616-840-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035247",
"telephone_number": "616-840-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "ELYSE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-31",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NM",
"license": "PT6173",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501303436",
"primary": true
}
],
"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 Oct 11, 2024; 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.