Individual provider Active NPI

David C Beckett, PT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1710101118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010865 Issued in MI
Practice address
3282 Clear Vista CT NE
Suite a
Grand Rapids, MI 49525-9477
Phone
(616) 365-2709
Fax
(616) 365-3174
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010865 MI Primary

Addresses

Primary practice location

3282 Clear Vista CT NE
Suite a
Grand Rapids, MI 49525-9477

Mailing address

5797 Jamail Dr NE
Belmont, MI 49306-8867
Phone (616) 245-3795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000994 MI Practitioner - Physical Therapist in Private Practice 0941246441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hulst Jepsen Physical Therapy IncGroup PAC ID 8325033285, 132 clinicians

Practice addresses (Care Compare)

2120 43Rd St SE
Suite 100
Grand Rapids, MI 49508-3712
Phone (616) 281-1144

4120 E Beltline Ave NE
Suite 200
Grand Rapids, MI 49525-9684
Phone (616) 365-2709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hulst Jepsen Physical Therapy Inc Physical Therapist CurrentSince May 23, 2005 Accepting new patients
Hulst Jepsen Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

3282 Clear Vista Ct NE
Ste A
Grand Rapids, MI 49525
Phone (616) 365-2709

2120 43rd St SE
Ste 100
Grand Rapids, MI 49508
Phone (616) 281-1144

4120 E Beltline Ave NE
Ste 200
Grand Rapids, MI 49525
Phone (616) 365-2709

Organizations & group practices 2

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710101118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5797 JAMAIL DR NE",
            "city": "BELMONT",
            "state": "MI",
            "postal_code": "493068867",
            "telephone_number": "616-245-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3282 CLEAR VISTA CT NE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259477",
            "telephone_number": "616-365-2709",
            "fax_number": "616-365-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKETT",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010865",
            "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 Jul 8, 2007; 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.