Individual provider Active NPI

Briana Virkstis

  • Physical Therapist
  • Caledonia, MI
National Provider Identifier
1275130106
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
7169 Kalamazoo Ave SE Ste 200
Caledonia, MI 49316-8146
Phone
(616) 265-2414
NPI assigned
Oct 5, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 NU Primary

Addresses

Primary practice location

7169 Kalamazoo Ave SE Ste 200
Caledonia, MI 49316-8146

Mailing address

4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300

Other identifiers 1

IdentifierTypeStateIssuer
5501016800OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116001166 MI Practitioner - Physical Therapist in Private Practice 1951712363 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hulst Jepsen Physical Therapy Inc Physical Therapist CurrentSince Oct 8, 2020 Accepting new patients

Locations

7169 Kalamazoo Ave SE
Ste 200
Caledonia, MI 49316
Phone (616) 265-2414

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

4761 Lake Michigan Dr NW
Ste A
Grand Rapids, MI 49534
Phone (616) 608-9978

5819 Balsam Dr
Hudsonville, MI 49426
Phone (616) 209-5435

721 3 Mile Rd NW
Ste 100
Walker, MI 49544
Phone (616) 265-2414

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": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1275130106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4761 LAKE MICHIGAN DR NW STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7169 KALAMAZOO AVE SE STE 200",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168146",
            "telephone_number": "616-265-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRKSTIS",
        "first_name": "BRIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5501016800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 9, 2020; 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.

Verify at the official NPI Registry.