Active NPI
Arben S Mandija, PT
- Physical Therapist
- Holland, MI
National Provider Identifier
1629170931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 854 S. Washington Ave
Suite 200
Holland, MI 49423 - Phone
- (616) 392-9430
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- 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 | MI | Primary |
Addresses
Primary practice location
854 S. Washington Ave
Suite 200
Holland, MI 49423
Mailing address
3262 Robinhood CT SE
Grand Rapids, MI 49546-2101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 550101137 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629170931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3262 ROBINHOOD CT SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "854 S. WASHINGTON AVE",
"address_2": "SUITE 200",
"city": "HOLLAND",
"state": "MI",
"postal_code": "49423",
"telephone_number": "616-392-9430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDIJA",
"first_name": "ARBEN",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.