Individual provider Active NPI

Judith Clare Birkmeier, P.T.

  • Physical Therapist
  • Portage, MI
National Provider Identifier
1780814715
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501003445 Issued in MI
Practice address
6016 Lovers LN
Ste 3
Portage, MI 49002-3050
Phone
(269) 329-0934
Fax
(269) 329-0965
NPI assigned
Jul 24, 2009
Last updated
Jul 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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 5501003445 MI Primary

Addresses

Primary practice location

6016 Lovers LN
Ste 3
Portage, MI 49002-3050

Mailing address

6016 Lovers LN
Ste 3
Portage, MI 49002-3050
Phone (269) 329-0934

Other names 1

  • Judith Clare Way Former name

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
5501003445MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Rehabilitation and Therapy LP Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Dery Rehabilitation Services, PC Past Accepting new patients
Alliance Physical Therapy Group LLC Physical Therapist PastSince Nov 11, 2010 Accepting new patients

Locations

5060 Cascade Rd SE
Ste A
Grand Rapids, MI 49546
Phone (616) 954-0950

901 W Main St
Lowell, MI 49331
Phone (616) 897-7055

3536 Meridian Crossings
Ste 240
Okemos, MI 48864
Phone (517) 347-2495

Organizations & group practices 3

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1780814715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 LOVERS LN",
            "address_2": "STE 3",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023050",
            "telephone_number": "269-329-0934",
            "fax_number": "269-329-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 LOVERS LN",
            "address_2": "STE 3",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023050",
            "telephone_number": "269-329-0934",
            "fax_number": "269-329-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKMEIER",
        "first_name": "JUDITH",
        "middle_name": "CLARE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "WAY",
            "middle_name": "CLARE",
            "credential": "P.T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.