Individual provider Active NPI

Brian Gilbert, M.S.P.T., OCS

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1316012420
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010834 Issued in MI
Practice address
5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808
Phone
(616) 954-0950
Fax
(616) 954-1728
NPI assigned
Nov 22, 2006
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 5501010834 MI Primary

Addresses

Primary practice location

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Mailing address

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808
Phone (616) 954-0950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000771 MI Practitioner - Physical Therapist in Private Practice 0547312654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501010834MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dery Rehabilitation Services, PC Past Accepting new patients
Center for Physical Rehabilitation Inc Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1316012420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-954-0950",
            "fax_number": "616-954-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-954-0950",
            "fax_number": "616-954-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "M.S.P.T., OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010834",
            "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 Feb 22, 2022; 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.