Organization Active NPI

Cascade Physical Therapy & Rehabilitation PC

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1568614105
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CASCADE PHYSICAL THERAPY & REHABILITATION PC
Practice address
4930 Cascade Rd SE Ste E
Grand Rapids, MI 49546-3884
Phone
(616) 942-0922
NPI assigned
Oct 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Sanjeev Thamman, MHS OTRNPI 1558547570
Title
Vice President
Phone
(616) 942-0922

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X MI Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

4930 Cascade Rd SE Ste E
Grand Rapids, MI 49546-3884

Mailing address

4930 Cascade Rd SE Ste E
Grand Rapids, MI 49546-3884
Phone (616) 942-0922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090202000510 MI Part B Supplier - Clinic/Group Practice 6406910629 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

4930 Cascade Rd SE
Ste E
Grand Rapids, MI 49546
Phone (616) 942-0922

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1568614105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 CASCADE RD SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463884",
            "telephone_number": "616-942-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 CASCADE RD SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463884",
            "telephone_number": "616-942-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE PHYSICAL THERAPY & REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "THAMMAN",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "616-942-0922",
        "authorized_official_credential": "MHS OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 9, 2016; 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.