Individual provider Active NPI

Lindsay Banachowski, PT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1558706689
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016187 Issued in MI
Practice address
150 Jefferson Ave SE
Suite 100
Grand Rapids, MI 49503-4306
Phone
(616) 284-3690
Fax
(616) 301-1320
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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 5501016187 MI Primary

Addresses

Primary practice location

150 Jefferson Ave SE
Suite 100
Grand Rapids, MI 49503-4306

Mailing address

607 Dewey Ave NW
Suite 300
Grand Rapids, MI 49504-7335
Phone (616) 356-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217001492 MI Practitioner - Physical Therapist in Private Practice 2163837568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

2373 64TH St SW
Suite 2100
Byron Center, MI 49315-7976
Phone (616) 235-3970

3380 44TH St SW
Grandville, MI 49418-2461
Phone (616) 233-3591

3686 32ND Ave
Suite 400
Hudsonville, MI 49426-8546
Phone (616) 377-1010

4085 Burton St SE
Suite 100
Grand Rapids, MI 49546-2444
Phone (616) 233-3599

6101 Kalamazoo Ave SE
Suite B
Grand Rapids, MI 49508-7886
Phone (616) 483-3478

933 3 Mile Rd NW
Suite 204
Grand Rapids, MI 49544-1673
Phone (616) 233-3592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016187MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Alliance Physical Therapy Group LLC Physical Therapist CurrentSince Mar 15, 2021 Accepting new patients

Locations

6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014

2373 64th St SW
Ste 2100
Byron Center, MI 49315
Phone (616) 235-3970

933 3 Mile Rd NW
Ste 204
Grand Rapids, MI 49544
Phone (616) 233-3592

150 Jefferson Ave SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 284-3690

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1558706689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 JEFFERSON AVE SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034306",
            "telephone_number": "616-284-3690",
            "fax_number": "616-301-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACHOWSKI",
        "first_name": "LINDSAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016187",
            "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 Aug 11, 2014; 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.