Individual provider Active NPI

Cameron Faller

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1396228615
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089
Phone
(616) 855-1508
Fax
(616) 855-1185
NPI assigned
Sep 12, 2018
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089

Mailing address

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003001220 MI Practitioner - Physical Therapist in Private Practice 9638421605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5429 Northland Dr NE
Suite a
Grand Rapids, MI 49525-1089
Phone (616) 855-0540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Contextual Human Health, Wellness, and Performance Physical Therapist CurrentSince Jan 21, 2024 Accepting new patients
Dynamic Movement and Recovery Physical Therapist CurrentSince Jun 5, 2022 Accepting new patients
Center for Physical Rehabilitation Inc Physical Therapist PastSince Sep 17, 2018 Accepting new patients

Locations

5429 Northland Dr NE
Ste A
Grand Rapids, MI 49525
Phone (616) 855-0540

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": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1396228615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "fax_number": "616-855-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "telephone_number": "616-855-1508",
            "fax_number": "616-855-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLER",
        "first_name": "CAMERON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.