Kevin Frederick Churchill, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501015557 Issued in MI

Practice address

4120 E Beltline NE
Suite 200
Grand Rapids, MI 49525

Phone

(616) 365-2709

Fax

(616) 785-1201

NPI assigned

Feb 15, 2012

Last updated

Jul 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hulst Jepsen Physical Therapy IncGroup PAC ID 8325033285, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hulst Jepsen Physical Therapy Inc

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1609957760
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1457624942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 5300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 E BELTLINE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-365-2709",
            "fax_number": "616-785-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "KEVIN",
        "middle_name": "FREDERICK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Chung, CRNA
• David B Chuol
• Caitlyn Marie Chupp
• Emily Ann Churchard, MPH, QIDP
• Alyssa Ashley Churchill, D.O.
• Brandon J Churchman, PA-C, DDS
• Louis Ciaramello
• Rachel Ciaramello, PHARMD
• Victoria Susan Ciavaglia, DPT
• Anina L Cicerone-Carder, PA-C

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.