Active NPI
Tabitha Bennett, PT, DPT
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1770290041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501302178
- Practice address
- 245 Cherry St SE Ste 102
Grand Rapids, MI 49503-4607 - Phone
- (269) 948-7489
- NPI assigned
- Nov 4, 2022
- 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 | 5501302178 | MI | Primary |
Addresses
Primary practice location
245 Cherry St SE Ste 102
Grand Rapids, MI 49503-4607
Mailing address
625 Kenmoor Ave
Ste 100
Grand Rapids, MI 49546
Other names 1
- Tabitha Sherk
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": "1667520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1770290041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 KENMOOR AVE",
"address_2": "STE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 CHERRY ST SE STE 102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034607",
"telephone_number": "269-948-7489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "TABITHA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-04",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501302178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TABITHA",
"last_name": "SHERK",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 4, 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.