Active NPI
Jessica Kuipers, DPT
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1750627915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501016006
- Practice address
- 4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300 - Phone
- (616) 791-7025
- Fax
- (616) 791-7233
- NPI assigned
- Dec 17, 2012
- Last updated
- Oct 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016006 | MI | Primary |
Addresses
Primary practice location
4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300
Mailing address
4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300
Phone (616) 791-7025
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501016006 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dery Rehabilitation Services, PC | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Lowell, MI
- NPI 1366588196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1750627915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4761 LAKE MICHIGAN DR NW STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495346300",
"telephone_number": "616-791-7025",
"fax_number": "616-791-7233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4761 LAKE MICHIGAN DR NW STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495346300",
"telephone_number": "616-791-7025",
"fax_number": "616-791-7233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUIPERS",
"first_name": "JESSICA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-17",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016006",
"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 Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.