Individual provider Active NPI

Aaron Overhiser, DPT

  • Physical Therapist
  • Holland, MI
National Provider Identifier
1770207409
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302280 Issued in MI
Practice address
11595 E Lakewood Blvd Ste 80
Holland, MI 49424-8695
Phone
(616) 594-2000
NPI assigned
Sep 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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 5501302280 MI Primary

Addresses

Primary practice location

11595 E Lakewood Blvd Ste 80
Holland, MI 49424-8695

Mailing address

6317 107TH Ave
South Haven, MI 49090-9381
Phone (269) 363-3236

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

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1770207409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6317 107TH AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909381",
            "telephone_number": "269-363-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11595 E LAKEWOOD BLVD STE 80",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248695",
            "telephone_number": "616-594-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERHISER",
        "first_name": "AARON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.