Renewed Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RENEWED PHYSICAL THERAPY LLC

Practice address

3423 Quincy St
Hudsonville, MI 49426-7835

Phone

(616) 797-1500

NPI assigned

Jul 25, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hope Marie Van DykeNPI 1508527631

Title

Owner, Physical Therapist

Phone

(616) 980-6574

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hope Marie Van Dyke, DPT, PT

  • Physical Therapist
  • Hudsonville, MI
  • NPI 1508527631
  Medicare reassignment Care Compare group NPD Authorized official
• Stacey Madeline Stephens, PT, DPT

  • Physical Therapist
  • Grand Rapids, MI
  • NPI 1831803410
  Medicare reassignment Care Compare group
• Glenn Ludgate Fitkin IV, PT, DPT

  • Physical Therapist
  • Wyoming, MI
  • NPI 1760134720
  Medicare reassignment NPD

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1811725286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3956 GLENVIEW CT",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268400",
            "telephone_number": "616-980-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 QUINCY ST",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267835",
            "telephone_number": "616-797-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "VAN DYKE",
        "authorized_official_first_name": "HOPE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "616-980-6574"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Anthony Raskey
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• William Jon Renkema, RN
• Adam Rezmer
• Mason David Riegel, PHYSICAL THERAPIST
• Kaelin Marie Roberts
• Michael Scott Ruszkowski, D.D.S.

• Physical Therapist in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.