Peter Lin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501302055 Issued in MI

Practice address

25 Conran Dr
Coopersville, MI 49404-1300

Phone

(616) 997-6172

Fax

(616) 965-2475

NPI assigned

Aug 5, 2022

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD
• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)
• Northern Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Lyndonville, VT
  • NPI 1164509980

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1346977626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CONRAN DR",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041300",
            "telephone_number": "616-997-6172",
            "fax_number": "616-965-2475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6173 Lake Michigan Dr Ste 6171",
            "address_purpose": "LOCATION",
            "city": "Allendale",
            "state": "MI",
            "postal_code": "494019244",
            "country_code": "US",
            "telephone_number": "616-895-4050",
            "fax_number": "616-965-2475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "PETER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Key2Happiness Counseling, LLC
• Marrielle Konkle, DDS
• Alysha Kropewnicki, CD(DONA)
• Corey Wayne Kuipers, PT
• Albert J Lafleur, D.D.S
• Jacob Colbert Lueder, D.D.S., M.S.
• Maxwell McDonald Jr.
• Katie Anne McNitt
• Laura Mervenne
• Ardwan Meshaal, DDS

• Physical Therapist in Coopersville, MI
• Providers in Coopersville, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.