Kailey Danaher
Individual provider Active NPI Physical Therapist · Grand Rapids, MI
NPI 1942926795 · NPPES record last updated Oct 13, 2022
Key facts
- NPI
- 1942926795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300 - Phone
- (616) 791-7025
- NPI assigned
- Oct 13, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hulst Jepsen Physical Therapy Inc
Practice addresses (Care Compare)
2120 43Rd St SE
Suite 100
Grand Rapids, MI 49508-3712
Phone (616) 281-1144
4761 Lake Michigan Dr NW
Suite a
Grand Rapids, MI 49534-6300
Phone (616) 791-7025
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221026000748 | MI | Practitioner - Physical Therapist in Private Practice | 0749656171 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieve Physical Therapy and Sports Rehab, LLC | Physical Therapist | Current |
Accepting new patients |
| Hulst Jepsen Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
Locations
2120 43rd St SE
Ste 100
Grand Rapids, MI 49508
Phone (616) 281-1144
4761 Lake Michigan Dr NW
Ste A
Grand Rapids, MI 49534
Phone (616) 608-9978
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
4761 Lake Michigan Dr NW Ste a
Grand Rapids, MI 49534-6300
Mailing address
PO Box 30516
Dept 5300
Lansing, MI 48909
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501302158 | Other | MI | STATE LICENSE |
Other providers in Grand Rapids, MI
- Julia Justine Damman
- Lindsay Jaye Coursen Dammar
- Christine Meredith Damon
- Caitlin Dampier
- Jessica Damveld
- Thomas E Dancey
- Sanjay Dandamudi
- Dandelion Counseling Incorporated
- Caitlyn Dandrow
- Darla Dane
All providers in Grand Rapids, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.