NPIMap

Organization Active NPI

Empowerme Rehabilitation Illinois, LLC

  • Multi-Specialty Clinic/Center
  • Holland, MI
National Provider Identifier
1548865876
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EMPOWERME REHABILITATION ILLINOIS, LLC
Practice address
340 W 40TH St
Holland, MI 49423-4600
Phone
(844) 502-7996
NPI assigned
Dec 3, 2020
Last updated
Oct 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
John David Church
Title
Vice President of Finance
Phone
(618) 972-5228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

340 W 40TH St
Holland, MI 49423-4600

Mailing address

PO Box 736005
Dallas, TX 75373-6005
Phone (844) 502-7996

Other practice location 1

5700 Water Tower Pl
Clarkston, MI 48346-2668
Phone (844) 502-7996

Other practice location 2

42010 7 Mile Rd
Northville, MI 48167-2222
Phone (844) 502-7996

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210205002328 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365718277 Receives reassigned benefits from 30 practitioners
Practice locations: Holland, MI; Brighton, MI; Ann Arbor, MI; Commerce Township, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Empowerme Rehabilitation Illinois LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1548865876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736005",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736005",
            "telephone_number": "844-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W 40TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234600",
            "telephone_number": "844-502-7996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Water Tower Pl",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483462668",
            "country_code": "US",
            "telephone_number": "844-502-7996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42010 7 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481672222",
            "country_code": "US",
            "telephone_number": "844-502-7996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMPOWERME REHABILITATION ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JOHN DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "618-972-5228"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 1, 2025; 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.