Kayle Ann Lavictoire, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016490 Issued in MI

Practice address

5500 Burton St SE
Grand Rapids, MI 49546-6711

Phone

(616) 840-7529

Fax

(616) 840-9693

NPI assigned

Mar 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD
• Mary Free Bed Rehabilitation Hospital

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
  • NPI 1053641589
  NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1972007771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468328",
            "telephone_number": "616-252-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 BURTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466711",
            "telephone_number": "616-840-7529",
            "fax_number": "616-840-9693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Cascade Rd SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468328",
            "country_code": "US",
            "telephone_number": "616-252-1530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVICTOIRE",
        "first_name": "KAYLE",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501016490",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas J Lauria, PA
• Taylor Lautzenhiser, MD
• Lavange Barth LLC
• Katlyn Anne Lavasseur, LCSW
• Christina Lavengood
• Heather Dawn Lavigne, N.P.
• Jennifer Lavigne, NP
• Jason Law, PT
• Christopher Edward Lawitzke, LMSW
• Marriah Lawler

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.