Kimberlee J Odonald PT PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

KIMBERLEE J ODONALD PT PC

Practice address

1330 W Washington
Greenville, MI 48838-2190

Phone

(616) 754-7040

Fax

(616) 754-7888

NPI assigned

Jan 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberlee J Odonald, PTNPI 1306021472

Title

President

Phone

(616) 754-7040

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberlee J Odonald, PT

  • Physical Therapist
  • Greenville, MI
  • NPI 1306021472
  NPD (past) Authorized official
• Shayna Michele Budres, D.P.T.

  • Physical Therapist
  • Greenville, MI
  • NPI 1275725533
  NPD (past)
• Todd Gerrit Cates, DPT

  • Physical Therapist
  • Greenville, MI
  • NPI 1003204371
  NPD (past)
• Nancy Sue Hock, OTR,L, CHT

  • Occupational Therapist
  • Grand Rapids, MI
  • NPI 1598976672
  NPD (past)
• Melissa Kae Syrjala, PTA

  • Physical Therapy Assistant
  • Greenville, MI
  • NPI 1801284179
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689731374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W WASHINGTON",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382190",
            "telephone_number": "616-754-7040",
            "fax_number": "616-754-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W WASHINGTON",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382190",
            "telephone_number": "616-754-7040",
            "fax_number": "616-754-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLEE J ODONALD PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODONALD",
        "authorized_official_first_name": "KIMBERLEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-754-7040",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2679020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30435",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody A Katerberg, LLMSW
• David I Kay, MD
• Tiffany Kelley, PHARMD
• James Howard Kelly, RPH
• Kevin T Oconnor DO PC
• Kimberly B Lavender, LLC
• Jenny E Kipp, DNP
• Tammy Kay Kirby, ARNP-C
• Rachel Kloosterman
• Catherine Anne Knisley, RPH

• Physical Therapy Clinic/Center in Greenville, MI
• Providers in Greenville, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.