Individual provider Active NPI

Lisa Marie Jonker, PT

  • Physical Therapist
  • Ionia, MI
National Provider Identifier
1932273083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004388 Issued in MI
Practice address
3751 S State Rd
Ionia, MI 48846
Phone
(616) 522-0066
Fax
(616) 527-1667
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5501004388 MI Primary

Addresses

Primary practice location

3751 S State Rd
Ionia, MI 48846

Mailing address

3751 S State Rd
Ionia, MI 48846
Phone (616) 522-0066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000987 MI Practitioner - Physical Therapist in Private Practice 9739368796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

400 Rounds Dr
Fenton, MI 48430-1724
Phone (810) 750-1996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501004388MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Sep 10, 2020 Accepting new patients

Locations

400 Rounds Dr
Fenton, MI 48430
Phone (810) 629-0530

3751 S State Rd
Ionia, MI 48846
Phone (616) 522-0066

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932273083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 S STATE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "48846",
            "telephone_number": "616-522-0066",
            "fax_number": "616-527-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 S STATE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "48846",
            "telephone_number": "616-522-0066",
            "fax_number": "616-527-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONKER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ionia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.