Edo Zylstra, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016106 Issued in MI

Practice address

4676 32ND Ave Ste C
Hudsonville, MI 49426-8015

Phone

(616) 263-6161

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Sport and Spine PT, Brighton, PLLC

  • Physical Therapy Clinic/Center
  • Brighton, CO
  • NPI 1669570016
  NPD Authorized official

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1710948757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 HIDE AWAY LN",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267373",
            "telephone_number": "303-263-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4676 32ND AVE STE C",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268015",
            "telephone_number": "616-263-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLSTRA",
        "first_name": "EDO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7515",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Kay Wustman, OD
• Kau Zong Yang, MSW
• Brian Joseph Yared, D.D.S.
• Carrie Ann Ysseldyke
• Scott Zychowski, DPT

• Physical Therapist in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.