NPIMap

Organization Active NPI

Good Life Therapy LLC

  • Physical Therapy Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1598169682
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
GOOD LIFE THERAPY LLC
Practice address
1331 Lake Dr SE
Suite 105
Grand Rapids, MI 49506-1674
Phone
(616) 248-9842
NPI assigned
Oct 17, 2014
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Ryan S Gary, PT, DPTNPI 1003247891
Title
Physical Therapist
Phone
(616) 248-9842

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1331 Lake Dr SE
Suite 105
Grand Rapids, MI 49506-1674

Mailing address

1331 Lake Dr SE Ste 105
Grand Rapids, MI 49506-1674

Other practice location 1

2500 E Beltline Ave SE Ste J
Grand Rapids, MI 49546-5987
Phone (616) 855-6588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141204001607 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345562187 Receives reassigned benefits from 10 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

1331 Lake Dr SE
Ste 105
Grand Rapids, MI 49506
Phone (616) 248-9842

2500 E Beltline Ave SE
Ste J
Grand Rapids, MI 49546
Phone (616) 248-9842

5435 28th Street Ct SE
#D1
Grand Rapids, MI 49546
Phone (616) 855-6588

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1598169682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 LAKE DR SE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 LAKE DR SE",
            "address_2": "SUITE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061674",
            "telephone_number": "616-248-9842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 E Beltline Ave SE Ste J",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495465987",
            "country_code": "US",
            "telephone_number": "616-855-6588",
            "fax_number": "616-248-9842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOOD LIFE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GARY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "616-248-9842",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 Sep 11, 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.