INDEPENDENCE REHAB LLC (NPI# 1427184589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427184589 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE REHAB LLC |
| Practice Address |
3753 Basswood Dr Sw Grandville MI 49418-2003 |
| Practice Telephone | 6163406407 |
| Practice Fax Number | 6163012882 |
| Mailing Telephone | 6163406407 |
| Mailing Fax Number | 6163012882 |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | MR. KIRK CHRISTOPHER RANDALL (OWNER) |
| Authorized Official Telephone | 6163406407 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5501005678 | MI | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073536413 | Independence Rehab LLC | Residential Treatment Facility, Physical Disabilities | 5241 Nichols Dr E, Lakeland, FL 33813-4077 | 2006-07-26 |
| 1588043020 | Independence Rehab LLC | Skilled Nursing Facility | 919 109th Ave Ne, Bellevue, WA 98004-4485 | 2015-05-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Independence Rehab LLC | 5314 N River Run Drive Ste 140, Provo, Utah 84604 |
| Street Address |
3753 BASSWOOD DR SW |
| City | GRANDVILLE |
| State | MI |
| Zip Code | 49418-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235172826 | Kirk Christopher Randall | Physical Therapist | 3753 Basswood Dr Sw, Grandville, MI 49418-2003 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144799669 | Holly Cieslinski | Occupational Therapist | 3550 Fairlines Ave, Grandville, MI 49418 | 2018-11-14 |
| 1639664857 | Athletico Ltd | Physical Therapist | 3819 Rivertown Pkwy Sw Ste 100, Grandville, MI 49418 | 2018-06-29 |
| 1437651916 | Great Lakes Wellness Counseling LLC | Counselor | 2900 Wilson Ave Suite 110, Grandville, MI 49418 | 2018-03-01 |
| 1780111765 | Jenna Sargent | Nurse Practitioner | 2845 44th St Sw, Ste 200, Grandville, MI 49418 | 2017-05-22 |
| 1881132827 | Laura Elizabeth Ramaker | Specialist/Technologist | 2787 Pine Dunes Ct Sw, Wyoming, MI 49418 | 2017-02-10 |
| 1689026130 | Charles Unseld | Hearing Instrument Specialist | O-38 44th St Sw, Grandville, MI 49418 | 2016-07-08 |
| 1972989655 | Laci Dawn Johncock | Physical Therapy Assistant | 2786 56th Street, Wyoming, MI 49418 | 2015-08-05 |
| 1891178570 | Joshua Kolman | Pharmacist | 3434 Century Center Dr Sw, Grandville, MI 49418 | 2015-06-30 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1124410808 | Kim Michelle Childress | Counselor | 4565 Wilson Ave Sw Ste 3a, Grandville, MI 49418 | 2015-03-04 |
| Find all providers in zip 49418 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679485 | Thrive Physical Therapy | Clinic/Center | 835 Mason St Ste A245, Dearborn, MI 48124-2231 | 2020-11-06 |
| 1700484482 | Redford Physical Therapy LLC | Clinic/Center | 25136 W 6 Mile Rd, Redford, MI 48240-2102 | 2020-10-14 |
| 1740894500 | Sara Sue Laisure | Clinic/Center | 1105 E 8th St, Traverse City, MI 49686-2936 | 2020-08-31 |
| 1578176269 | Pro-line Physical Therapy, LLC | Clinic/Center | 25899 W 12 Mile Rd Ste 335, Southfield, MI 48034-8343 | 2020-08-24 |
| 1326650011 | Physical Therapy Center for Sports and Performing Arts, Pllc | Clinic/Center | 30475 Stephenson Hwy, Madison Heights, MI 48071-1615 | 2020-08-23 |
| 1770194607 | Restorative Rehabilitation Inc | Clinic/Center | 9228 Pelham Rd, Taylor, MI 48180-3832 | 2020-08-13 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1114537719 | Axpert Rehab Care, LLC | Clinic/Center | 22830 Kelly Rd, Eastpointe, MI 48021-2072 | 2020-08-07 |
| 1619586898 | Right Health, PC | Clinic/Center | 28345 Beck Rd Ste 412, Wixom, MI 48393-4745 | 2020-07-23 |
| 1497378368 | Launch Pediatric Rehab | Clinic/Center | 13448 Greenbriar Dr, Grand Haven, MI 49417-9161 | 2020-05-26 |
| Find all providers with the same taxonomy | ||||
| City | GRANDVILLE |
| Zip Code | 49418 |
Please comment or provide details below to improve the information on INDEPENDENCE REHAB LLC.
| 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.