Individual provider Active NPI

Dustin Allen Karlik, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1881178671
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018848 Issued in MI
Practice address
45 Ottawa Ave SW Ste D
Grand Rapids, MI 49503-4010
Phone
(616) 323-1700
NPI assigned
Sep 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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 5501018848 MI Primary

Addresses

Primary practice location

45 Ottawa Ave SW Ste D
Grand Rapids, MI 49503-4010

Mailing address

45 Ottawa Ave SW Ste D
Grand Rapids, MI 49503-4010
Phone (616) 323-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003002015 MI Practitioner - Physical Therapist in Private Practice 6406108380 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018848MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Rehabilitation and Therapy LP Physical Therapist CurrentSince Mar 2, 2020 Accepting new patients
Center for Physical Rehabilitation Inc Physical Therapist PastSince Feb 16, 2020 Accepting new patients

Locations

45 Ottawa Ave SW
Ste D
Grand Rapids, MI 49503
Phone (616) 323-1700

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1881178671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 OTTAWA AVE SW STE D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034010",
            "telephone_number": "616-323-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 OTTAWA AVE SW STE D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034010",
            "telephone_number": "616-323-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLIK",
        "first_name": "DUSTIN",
        "middle_name": "ALLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018848",
            "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 Feb 14, 2020; 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.