Emily Eisen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018371 Issued in MI

Practice address

437 Butternut Dr
Holland, MI 49424-1577

Phone

(616) 355-3055

Fax

(616) 317-5269

NPI assigned

Nov 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 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 and National Provider Directory roles.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1568976728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412031",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412031",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 BUTTERNUT DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494241577",
            "telephone_number": "616-355-3055",
            "fax_number": "616-317-5269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3826 44th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495123919",
            "country_code": "US",
            "telephone_number": "616-554-0918",
            "fax_number": "616-554-3079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISEN",
        "first_name": "EMILY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5501018371",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Ruth Eggerding, LLPC
• Tate A Eggers, R.PH.
• John Louis Ehlert, M.D.
• Sharon Diane Eicher
• Carleigh Jo Eidson, OTR/L
• Melissa Marie Eisenhauer, PA
• Leah Lin Eisenlohr
• Corie Michelle Eklov, MD
• Dawn Marie Eklund
• Martha M. Elafros, OTR

• Physical Therapist in Holland, MI
• Providers in Holland, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.