Individual provider Active NPI

Jill Margaret Holkeboer, MSPT

  • Orthopedic Physical Therapist
  • Ada, MI
National Provider Identifier
1699984450
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501010191 Issued in MI
Practice address
7575 E Fulton St
Ada, MI 49355-0001
Phone
(616) 787-1792
Fax
(616) 787-6195
NPI assigned
May 21, 2007
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5501010191 MI Primary

Addresses

Primary practice location

7575 E Fulton St
Ada, MI 49355-0001

Mailing address

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504-7335
Phone (616) 246-5789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303002190 MI Practitioner - Physical Therapist in Private Practice 4183051121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

1915 Georgetown Ctr Dr
Suite 102
Jenison, MI 49428-7121
Phone (616) 233-5483

2373 64TH St SW
Suite 2100
Byron Center, MI 49315-7976
Phone (616) 235-3970

3380 44TH St SW
Grandville, MI 49418-2461
Phone (616) 233-3591

3686 32ND Ave
Suite 400
Hudsonville, MI 49426-8546
Phone (616) 377-1010

545 S State St
Suite H
Sparta, MI 49345-1593
Phone (616) 275-8014

933 3 Mile Rd NW
Suite 204
Grand Rapids, MI 49544-1673
Phone (616) 233-3592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501010191MIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advent Rehabilitation, LLC Orthopedic CurrentSince May 17, 2021 Accepting new patients
Alliance Physical Therapy Group LLC CurrentSince Feb 13, 2020 Accepting new patients
Advent Rehabilitation, LLC Orthopedic CurrentSince May 17, 2021 Accepting new patients

Locations

6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014

1471 E Beltline Ave NE
Ste 104
Grand Rapids, MI 49525
Phone (616) 233-3596

150 Jefferson Ave SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 284-3690

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

545 S State St
Ste H
Sparta, MI 49345
Phone (616) 275-8014

1175 Wilson Ave NW
Walker, MI 49534
Phone (616) 284-3686

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1699984450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW",
            "address_2": "STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-246-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 E FULTON ST",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493550001",
            "telephone_number": "616-787-1792",
            "fax_number": "616-787-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLKEBOER",
        "first_name": "JILL",
        "middle_name": "MARGARET",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501010191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.