Haley Coda, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018850 Issued in MI

Practice address

1264 Plainfield Ave NE
Grand Rapids, MI 49505-4929

Phone

(616) 888-7993

Fax

(616) 432-2924

NPI assigned

Nov 7, 2018

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

• Haley Dekkinga Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD
• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)
• Northern Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Lyndonville, VT
  • NPI 1164509980

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1689142747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054929",
            "telephone_number": "616-888-7993",
            "fax_number": "616-432-2924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17615 W Moore",
            "address_purpose": "LOCATION",
            "city": "Grant",
            "state": "MI",
            "postal_code": "493279408",
            "country_code": "US",
            "telephone_number": "231-834-0208",
            "fax_number": "616-965-2475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CODA",
        "first_name": "HALEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "DEKKINGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kendra Rose Coburn, CPHT
• Anne Cochran, PA
• Jaclyn R Cochrane, PA-C
• John Tyler Cochrane, DO
• Shayne Cochrane
• Rebecca Jeanne Codere, M.A CCC-SLP
• Codi M Ponte Counseling LLC
• Angelina Cody
• Shannon Lynn Coe, LLMSW
• Cheyanne Coffin

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.