Benjamin R Eggleston

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019460 Issued in MI

Practice address

1736 Gezon Pkwy SW Ste 100
Wyoming, MI 49519-9525

Phone

(616) 249-0750

NPI assigned

Jan 3, 2020

Last updated

Jan 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Physical Rehabilitation and Therapy LP

  • Physical Therapy Clinic/Center
  • Grand Rapids, MI
  • NPI 1902288863
  Medicare reassignment
• Center for Physical Rehabilitation Inc

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1568416337
  NPD (past)

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1588203947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-249-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 GEZON PKWY SW STE 100",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199525",
            "telephone_number": "616-249-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGLESTON",
        "first_name": "BENJAMIN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Edozie
• Lynda Edsall
• Stefanie Edwards
• Adam William Eggert, DO
• Amber Renee Eggleston, FNP
• Heidi M Egloff, MD
• Megan Elizabeth Eiford-Noonan, RN
• Emme P Ekanem
• Jodie Elder, PHARMD
• Renee J Elderkin, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.