Individual provider Active NPI

Rene Louise Manker

  • Pediatric Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1639218050
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
5501001445 Issued in MI
Practice address
3351 Eagle Run Dr NE
Grand Rapids, MI 49525-7053
Phone
(616) 365-8920
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501001445 MI
Pediatric Physical Therapist 2251P0200X 5501001445 MI Primary

Addresses

Primary practice location

3351 Eagle Run Dr NE
Grand Rapids, MI 49525-7053

Mailing address

3845 Algansee Dr NE
Grand Rapids, MI 49525-2059
Phone (616) 364-4957

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501001445MIMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Resources and Institute for Neuropsychological Services Physical Therapist PastSince Apr 23, 2009 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639218050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 ALGANSEE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252059",
            "telephone_number": "616-364-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EAGLE RUN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257053",
            "telephone_number": "616-365-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKER",
        "first_name": "RENE",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501001445",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MI",
            "license": "5501001445",
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.