Great Lakes Physical Therapy-North Muskegon, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011276 Issued in MI

Legal business name

GREAT LAKES PHYSICAL THERAPY-NORTH MUSKEGON, LLC

Practice address

2045 Holton Rd
North Muskegon, MI 49445-1535

Phone

(231) 744-0077

Fax

(231) 744-0030

NPI assigned

Mar 27, 2013

Last updated

Mar 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey A Eaton, MS, PT, FAFSNPI 1033204870

Title

Owner

Phone

(231) 744-0077

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Allen Eaton

  • Physical Therapist
  • Muskegon, MI
  • NPI 1033204870
  Authorized official Same address or phone

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1265774368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 HOLTON RD",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494451535",
            "telephone_number": "231-744-0077",
            "fax_number": "231-744-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 HOLTON RD",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494451535",
            "telephone_number": "231-744-0077",
            "fax_number": "231-744-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PHYSICAL THERAPY-NORTH MUSKEGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-744-0077",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, PT, FAFS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4717630",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30609",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Fosse, DDS
• Noelle K Franklyn, MD
• Susan Renee Gerstweiler, LMSW
• Terralee Glenn
• Great Lakes Physical Therapies
• Hackley Professional Pharmacy Inc (Mercy Health Pharmacy - North Muskegon)
• Mary Jane Hardy
• Leslie Hollman, PHARMD
• HPCN (Harbour View Family Medicine)
• Laura Ann Inman, LLPC

• Physical Therapist in North Muskegon, MI
• Providers in North Muskegon, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.