Individual provider Active NPI

Kyle R Wesche, DPT

  • Physical Therapist
  • Grant, MI
National Provider Identifier
1295214906
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
17615 W Moore
Grant, MI 49327-9408
Phone
(231) 834-0208
NPI assigned
Aug 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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 Primary

Addresses

Primary practice location

17615 W Moore
Grant, MI 49327-9408

Mailing address

4240 Meadowood CT
Hudsonville, MI 49426-8667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025001960 MI Practitioner - Physical Therapist in Private Practice 2567794472 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Sep 16, 2019 Accepting new patients
Stay Well Physical Therapy and Wellness LLC Physical Therapist Past Accepting new patients
Ivyrehab Northern PT, LLC Past Accepting new patients
Northern Physical Therapy PC Physical Therapist Past Accepting new patients

Locations

400 Rounds Dr
Fenton, MI 48430
Phone (810) 629-0530

319 S Bridge St
Linden, MI 48451
Phone (810) 735-0010

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

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.

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1295214906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 MEADOWOOD CT",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17615 W MOORE",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493279408",
            "telephone_number": "231-834-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESCHE",
        "first_name": "KYLE",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.