NPIMap

Organization Active NPI

Hanneken Physical Therapy LLC

  • Physical Therapist
  • Holland, MI
National Provider Identifier
1528080629
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501003223 Issued in MI
Legal business name
HANNEKEN PHYSICAL THERAPY LLC
Practice address
286 Hoover Blvd
Holland, MI 49423-0286
Phone
(616) 392-2172
Fax
(616) 392-1726
NPI assigned
Jul 25, 2006
Last updated
Sep 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Vincent Hanneken, PTNPI 1912921933
Title
Owner/PT
Phone
(616) 392-2172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5501003223 MI Primary

Addresses

Primary practice location

286 Hoover Blvd
Holland, MI 49423-0286

Mailing address

286 Hoover Blvd
Holland, MI 49423-0286
Phone (616) 392-2172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060908000193 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1658375480 Receives reassigned benefits from 13 practitioners
Practice locations: Holland, MI

National Provider Directory

National Provider Directory

Locations

286 Hoover Blvd
Holland, MI 49423
Phone (616) 392-2172

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1528080629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494230286",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494230286",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNEKEN PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "HANNEKEN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "616-392-2172",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.