Individual provider Active NPI

Jessica Lee Buikema, DPT

  • Physical Therapist
  • Caledonia, MI
National Provider Identifier
1245636711
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016950 Issued in MI
Practice address
9028 N Rodgers Dr
Suite J
Caledonia, MI 49316-9786
Phone
(616) 891-0600
Fax
(616) 456-8208
NPI assigned
Nov 11, 2014
Last updated
Dec 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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 5501016950 MI Primary

Addresses

Primary practice location

9028 N Rodgers Dr
Suite J
Caledonia, MI 49316-9786

Mailing address

2120 43Rd St SE
Suite 100
Grand Rapids, MI 49508-3772
Phone (616) 281-1144

Other identifiers 1

IdentifierTypeStateIssuer
1245636711MedicaidMI

Other names 1

  • Jessica Lee Wilkins Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141217002553 MI Practitioner - Physical Therapist in Private Practice 2365765690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
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)

9028 N Rodgers CT SE
Suite J
Caledonia, MI 49316-7786
Phone (616) 890-0600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hulst Jepsen Physical Therapy Inc Physical Therapist CurrentSince Jun 27, 2016 Accepting new patients

Locations

9028 N Rodgers Ct SE
Ste J
Caledonia, MI 49316
Phone (616) 890-0600

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

5136 Cascade Rd SE
Ste 1C
Grand Rapids, MI 49546
Phone (616) 301-1215

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": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1245636711",
    "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": "616-456-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9028 N RODGERS DR",
            "address_2": "SUITE J",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169786",
            "telephone_number": "616-891-0600",
            "fax_number": "616-456-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUIKEMA",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245636711",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WILKINS",
            "middle_name": "LEE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.