Active NPI
Kelly Pines, PT
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1689176133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 625 Kenmoor Ave Suite 306
Grand Rapids, MI 49546 - Phone
- (616) 942-5744
- NPI assigned
- Mar 1, 2018
- 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 | Primary |
Addresses
Primary practice location
625 Kenmoor Ave Suite 306
Grand Rapids, MI 49546
Mailing address
4493 Stable Dr
Hudsonville, MI 49426
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519862400000",
"number": "1689176133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4493 STABLE DR",
"city": "HUDSONVILLE",
"state": "MI",
"postal_code": "49426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 KENMOOR AVE SUITE 306",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-942-5744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINES",
"first_name": "KELLY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-01",
"last_updated": "2018-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Health Services
- Pine Rest Christian Mental Heatth Services
- Sadie Marie Pingel
- Laura Pingston, B.S.
- Erinn Lynn Pinkley
- Larry Pinter, M.D.
- Jared Piotrowski
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.