Eileen Marie Kishman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501003198 Issued in MI

Practice address

5340 Plaza Ave
Suite 3
Hudsonville, MI 49426

Phone

(616) 608-8922

NPI assigned

Aug 27, 2007

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 names 1

• Eileen Marie Kennedy Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hulst Jepsen Physical Therapy IncGroup PAC ID 8325033285, 132 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.

• Hulst Jepsen Physical Therapy Inc

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1609957760
  Medicare reassignment Care Compare group NPD
• Stanton Crossings Physical Therapy LLC

  • Physical Therapist
  • West Olive, MI
  • NPI 1609802313
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1609069244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 5300",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48909",
            "telephone_number": "616-356-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLAZA AVE",
            "address_2": "SUITE 3",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "49426",
            "telephone_number": "616-608-8922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15151 Stanton St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "West Olive",
            "state": "MI",
            "postal_code": "494608543",
            "country_code": "US",
            "telephone_number": "616-296-9235",
            "fax_number": "616-296-9236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISHMAN",
        "first_name": "EILEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "KENNEDY",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keith Foisy Clinical Services PLLC
• Jo Anna Kelly, LLPC
• Lisa Marie Keskitalo, LMSW
• Jacob Keuning
• Kevin J. Piebenga D.P.M. P.C.
• Nicholas Andrew Kisielewski
• Scott T Kleinert, PA
• Mary Lynne Kleis, OTR/L, CHT, CLT
• Jordan Elizabeth Knot
• Olivia Koole

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.