JODIE MEGAN BLAKE (NPI# 1154644136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154644136 |
| Entity Type | Individual |
| Full Name | JODIE MEGAN BLAKE |
| Credential | PT |
| Practice Address |
4069 Lake Dr Se Suite 114 Grand Rapids MI 49546-8816 |
| Mailing Address |
4085 Burton St Se Suite 200 Grand Rapids MI 49546-2444 |
| Practice Telephone | 6167268365 |
| Practice Fax Number | 6167268364 |
| Mailing Telephone | 6169744466 |
| Mailing Fax Number | 6169744582 |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2010-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 5501011217 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4069 LAKE DR SE SUITE 114 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811983000 | Spectrum Health | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 210, Grand Rapids, MI 49546-8816 | 2005-09-22 |
| 1184070807 | Danielle Wentworth | Audiologist | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2016-05-12 |
| 1205253424 | Elizabeth House | Physician Assistant | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2014-03-26 |
| 1043655780 | Spectrum Health Primary Care Partners | Nutritionist | 4069 Lake Dr Se, Ste. 315, Grand Rapids, MI 49546-8816 | 2013-05-08 |
| 1790025898 | George Torao Sugiyama | Surgery | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2013-02-26 |
| 1639442791 | Debra Ann West | Audiologist | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2012-02-20 |
| 1982976924 | Ashley Lucas | Physician Assistant | 4069 Lake Dr Se, Suite 117, Grand Rapids, MI 49546-8816 | 2012-02-07 |
| 1861762122 | Carley Therese Flegler | Physician Assistant | 4069 Lake Dr Se, Suite 313, Grand Rapids, MI 49546-8816 | 2012-01-04 |
| 1013227156 | Spectrum Health Primary Care Partners | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 | 2010-10-07 |
| 1285944322 | Spectrum Health Primary Care Partners | Durable Medical Equipment & Medical Supplies | 4069 Lake Dr Se, Suite 314, Grand Rapids, MI 49546-8816 | 2010-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991392 | Daniel Paul Swanson | Physical Therapist | 2849 Michigan St Ne Ste 100, Grand Rapids, MI 49506-1216 | 2020-10-26 |
| 1902454820 | Nicholas Vandermyde | Physical Therapist | 2991 Deli Dr Ne, Grand Rapids, MI 49525-3130 | 2019-09-04 |
| 1811545031 | Kyle Vanderwoude | Physical Therapist | 933 3 Mile Rd Nw Ste 104, Grand Rapids, MI 49544-1673 | 2019-08-30 |
| 1881241032 | Peter Curtis | Physical Therapist | 120 43rd St Se # 100, Grand Rapids, MI 49548-3354 | 2019-08-22 |
| 1750934170 | Alexis Cherven | Physical Therapist | 4787 Shady Pine Ln Se, Grand Rapids, MI 49546-6334 | 2019-07-24 |
| 1386100956 | Brady Eaton Smith | Physical Therapist | 1471 E Beltline Ave Ne Ste 104, Grand Rapids, MI 49525-4548 | 2019-02-19 |
| 1487126355 | Kathleen Ann Moelker | Physical Therapist | 2100 Raybrook St Se Ste 303, Grand Rapids, MI 49546-5783 | 2018-12-17 |
| 1023587946 | Counterstrain Physical Therapy Pllc | Physical Therapist | 3501 Lake Eastbrook Blvd Se Ste 138, Grand Rapids, MI 49546-5939 | 2018-11-20 |
| 1639648728 | Elina Simonen | Physical Therapist | 630 Kenmoor Ave Se Ste 200, Grand Rapids, MI 49546-8626 | 2018-11-19 |
| 1972071504 | Stacie Bronkema | Physical Therapist | 1430 Monroe Ave Nw Ste 120, Grand Rapids, MI 49505-4678 | 2018-11-13 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.