Active NPI
Jessica J Meengs, PT, DPT
- Physical Therapist
- Spring Lake, MI
National Provider Identifier
1609488311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501019669
- Practice address
- 18000 Cove St Ste 202
Spring Lake, MI 49456-1383 - Phone
- (616) 847-1280
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501019669 | MI | Primary |
Addresses
Primary practice location
18000 Cove St Ste 202
Spring Lake, MI 49456-1383
Mailing address
18000 Cove St Ste 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18000 Cove St
Spring Lake, MI 49456-1383
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501019669 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoreline Sport & Spine PLLC | Physical Therapist | Current | Accepting new patients |
| Shoreline Sport & Spine PLLC | Physical Therapist | Current | Accepting new patients |
Locations
18000 Cove St
Ste 202
Spring Lake, MI 49456
Phone (616) 847-1280
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1609488311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18000 COVE ST STE 202",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494561383",
"telephone_number": "616-847-1280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18000 COVE ST STE 202",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494561383",
"telephone_number": "616-847-1280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEENGS",
"first_name": "JESSICA",
"middle_name": "J",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-24",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501019669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.