Individual provider Active NPI

Danielle Campbell, PT, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1740891175
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019653 Issued in MI
Practice address
5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089
Phone
(616) 855-0540
Fax
(616) 855-1185
NPI assigned
Aug 10, 2020
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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 5501019653 MI Primary

Addresses

Primary practice location

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089

Mailing address

5429 Northland Dr NE Ste a
Grand Rapids, MI 49525-1089
Phone (616) 855-0540

Other practice location 1

4950 Plainfield Ave NE Ste A
Grand Rapids, MI 49525-1059
Phone (616) 855-0540

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019653MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Contextual Human Health, Wellness, and Performance Physical Therapist CurrentSince Jan 14, 2024 Accepting new patients

Locations

5429 Northland Dr NE
Ste A
Grand Rapids, MI 49525
Phone (616) 855-0540

Organizations & group practices 1

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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1740891175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "telephone_number": "616-855-0540",
            "fax_number": "616-855-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 NORTHLAND DR NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251089",
            "telephone_number": "616-855-0540",
            "fax_number": "616-855-1185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4950 Plainfield Ave NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495251059",
            "country_code": "US",
            "telephone_number": "616-855-0540",
            "fax_number": "616-855-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DANIELLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019653",
            "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 Jun 22, 2021; 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.