Kristy Graham

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501015645 Issued in MI

Practice address

5722 Metro Way SW
Wyoming, MI 49519-9524

Phone

(616) 840-7529

Fax

(616) 840-9693

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristy Vandriessche Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1992208847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495196439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 METRO WAY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199524",
            "telephone_number": "616-840-7529",
            "fax_number": "616-840-9693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 44th St SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495196439",
            "country_code": "US",
            "telephone_number": "616-252-8308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501015645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "VANDRIESSCHE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Ann Grabill, LLPC
• Grace Communities (Grace Wyoming)
• Monika B Graef, MA
• Donald Gene Graham, RT(R)
• Kerry Graham
• Grand Rapids Medical Center Inc
• Grand Rapids Surgical Associates, PLLC
• Grand River Surgery, PLLC
• Grandville Dental Health Center PC
• Great Lakes Healthcare Resources-Lakeshore LLC

• Orthopedic Physical Therapist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.