Individual provider Active NPI

Samuel Freestone, PT

  • Physical Therapist
  • Holland, MI
National Provider Identifier
1881205045
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019656 Issued in MI
Practice address
601 Michigan Ave Ste 220
Holland, MI 49423-4951
Phone
(616) 355-4284
Fax
(616) 355-4285
NPI assigned
Aug 12, 2020
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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 5501019656 MI Primary

Addresses

Primary practice location

601 Michigan Ave Ste 220
Holland, MI 49423-4951

Mailing address

607 Dewey Ave NW Ste 300
Grand Rapids, MI 49504-5283
Phone (616) 356-5000

Other practice location 1

9479 Riley St # 210215
Zeeland, MI 49464-8747
Phone (616) 300-9498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827000553 MI Practitioner - Physical Therapist in Private Practice 7214354877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6016 Lovers LN
Suite 3
Portage, MI 49002-3050

607 Dewey Ave NW
Suite 300
Grand Rapids, MI 49504-5283

625 Kenmoor Ave SE
Grand Rapids, MI 49546-2395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019656MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy Group LLC Physical Therapist CurrentSince Aug 12, 2020 Accepting new patients

Locations

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

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

Organizations & group practices 1

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1881205045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045283",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MICHIGAN AVE STE 220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234951",
            "telephone_number": "616-355-4284",
            "fax_number": "616-355-4285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9479 Riley St # 210215",
            "address_purpose": "LOCATION",
            "city": "Zeeland",
            "state": "MI",
            "postal_code": "494648747",
            "country_code": "US",
            "telephone_number": "616-300-9498",
            "fax_number": "866-245-5601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREESTONE",
        "first_name": "SAMUEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019656",
            "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 Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.