DR. MATTHEW CHARLES AXTMAN (NPI# 1255478988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255478988 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW CHARLES AXTMAN |
| Credential | DO |
| Practice Address |
4100 Lake Dr Se Ste 300 Grand Rapids MI 49546-8292 |
| Mailing Address |
100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162678860 |
| Practice Fax Number | 6162678442 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 5101019792 | MI | Allopathic & Osteopathic Physicians |
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
5101019792 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4100 LAKE DR SE STE 300 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366438632 | Spectrum Health Hospitals | Clinic/Center | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2005-09-22 |
| 1073146411 | James Walejewski | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2020-02-13 |
| 1811458557 | Michelle Kuzma | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2019-03-26 |
| 1063943991 | Maggie Anstett | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2017-03-22 |
| 1851746671 | Luke Murray | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2016-04-29 |
| 1942665237 | Alyssa Susanne Baker | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-31 |
| 1619332806 | Elizabeth Albert | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-15 |
| 1609247618 | Rebecca Preston | Psychologist | 4100 Lake Dr Se, Suite B01, Grand Rapids, MI 49546-8292 | 2015-10-16 |
| 1255708921 | Timothy Glerum | Nurse Practitioner | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2015-08-28 |
| 1730556796 | Samantha Ford | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2015-08-26 |
| 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 | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033503594 | Jacob H Reisner | Physical Medicine & Rehabilitation | 4100 Lake Dr Se Ste 300, Grand Rapids, MI 49546-8292 | 2015-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326583170 | John Penley | Physical Medicine & Rehabilitation | 1630 Bogie Lake Rd, White Lake, MI 48383 | 2017-01-04 |
| 1043360720 | Matthew S Woodruff | Physical Medicine & Rehabilitation | 2364 Redbud Dr, Howell, MI 48855-6410 | 2007-01-12 |
| 1417004938 | Margaret K Frens | Physical Medicine & Rehabilitation | 494 W 17th St Unit 2, Holland, MI 49423-3437 | 2007-01-05 |
| 1760455513 | Sarah Bethany Mcdade | Physical Medicine & Rehabilitation | 27209 Lahser Rd, Suite 221, Southfield, MI 48034-8401 | 2006-02-10 |
| 1164072732 | Travis Kiser | Physical Medicine & Rehabilitation | 1720 Abbey Rd Ste A, East Lansing, MI 48823-6363 | 2019-09-16 |
| 1912409897 | Gary Kufel | Physical Medicine & Rehabilitation | 24 Frank Lloyd Wright Dr, Ann Arbor, MI 48105-9484 | 2018-03-06 |
| 1225539364 | Christopher James Hendrickson | Physical Medicine & Rehabilitation | 901 Lakeshore Dr, Ishpeming, MI 49849-1367 | 2018-02-23 |
| 1104337120 | Ivyrehab Michigan, LLC | Physical Medicine & Rehabilitation | 400 Rounds Dr, Fenton, MI 48430-1724 | 2017-10-17 |
| 1679092696 | Kraig Carpenter | Physical Medicine & Rehabilitation | 10809 S Saginaw St, Grand Blanc, MI 48439-7033 | 2017-09-11 |
| 1396288031 | Wellness Medical P.C. D/b/a Somerset Regenerative Medicine | Physical Medicine & Rehabilitation | 1080 Kirts Blvd, Suite 700, Troy, MI 48084-4881 | 2016-11-29 |
| Find all providers with the same taxonomy | ||||
| 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.