DR. JESUDIAN BODDU (NPI# 1831315712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831315712 |
| Entity Type | Individual |
| Full Name | DR. JESUDIAN BODDU |
| Credential | DPT |
| Practice Address |
1447 E Grand River Ave Portland MI 48875-1631 |
| Mailing Address |
6910 Maynard Rd Portland MI 48875-9687 |
| Practice Telephone | 5176471000 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 5501013128 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1447 E GRAND RIVER AVE |
| City | PORTLAND |
| State | MI |
| Zip Code | 48875-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083624969 | Health Source Physical Therapy Center, Inc. | Clinic/Center | 1447 E Grand River Ave, Portland, MI 48875-1631 | 2006-08-09 |
| 1629697461 | Horizon Psychological Services, Pllc. | Psychologist | 1447 E Grand River Ave, Portland, MI 48875-1631 | 2020-04-12 |
| 1801150727 | Hiral R Patel | Psychologist | 1447 E Grand River Ave, Portland, MI 48875-1631 | 2012-06-25 |
| 1023235777 | Jaya Prakash Boddu | Physical Therapist | 1447 E Grand River Ave, Health Source Physical Therapy Center,inc., Portland, MI 48875-9687 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750635025 | Gretchen Findlay | Speech-Language Pathologist | 1330 E. Grand River Ave., Suite B, Portland, MI 48875 | 2012-11-07 |
| 1902970734 | Roger Duane Miller | Dentist | 811 West Grand River Ave, Portland, MI 48875 | 2006-11-20 |
| 1174612618 | Tom's Pharmacy LLC | Pharmacy | 1462 E Grand River Ave, Portland, MI 48875 | 2006-10-12 |
| 1033168828 | Jami M. Schneider | Dentist | 119 Bridge St., Portland, MI 48875 | 2006-05-09 |
| 1134197593 | Charlene Ann Pahl | Social Worker | 212 Kent St Ste 5, Child and Family Wellness Counseling Ctr, Portland, MI 48875 | 2006-03-10 |
| 1932187911 | Suzanne R Maystead | Optometrist | 1311 E Bridge Street, Portland, MI 48875 | 2006-01-09 |
| 1407143811 | Nicole Ann Mccrumb | Pharmacist | 1339 E Grand River Ave, Portland, MI 48875 | 2011-07-06 |
| 1629617402 | Roger A Doak | Specialist/Technologist | 1100 Ionia Rd, Portland, MI 48875-1035 | 2019-12-27 |
| 1518312032 | Brenda Hiemstra | Technician, Other | 120 Bethel Dr, Portland, MI 48875-1104 | 2016-05-03 |
| 1750574950 | Judy Ann Fryover | Nurse Practitioner | 427 W Grand River Ave, Portland, MI 48875-1122 | 2007-08-21 |
| Find all providers in zip 48875 | ||||
| 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 |
|---|---|---|---|---|
| 1356942221 | Joseph Cody Brainard | Physical Therapist | 4416 Ne Simpson St, Portland, OR 97218-1446 | 2020-11-05 |
| 1497355978 | Ptmobile Physical Therapy LLC | Physical Therapist | 9505 Sw 50th Ave, Portland, OR 97219-5159 | 2020-10-26 |
| 1376142133 | Randy Dittmar | Physical Therapist | 10120 Sw Park Way, Portland, OR 97225-5008 | 2020-10-22 |
| 1386250058 | Christopher Choi | Physical Therapist | 1307 Ne 102nd Ave Ste T1, Portland, OR 97220-3980 | 2020-09-18 |
| 1063026987 | Sara Marie Lindauer | Physical Therapist | 3934 Ne Martin Luther King Jr Blvd Ste 203, Portland, OR 97212-1153 | 2020-09-08 |
| 1891307492 | Emily Fleischman | Physical Therapist | 2714 Ne 60th Ave, Portland, OR 97213-3906 | 2020-08-17 |
| 1083224034 | Matthew Morris | Physical Therapist | 1364 Congress St Ste 3, Portland, ME 04102-2170 | 2020-08-05 |
| 1871101634 | Liz Ruegg Physical Therapy LLC | Physical Therapist | 2903 Se Brooklyn St, Portland, OR 97202-2026 | 2020-07-17 |
| 1770101776 | Taylor Eckel | Physical Therapist | 818 Nw 14th Ave, Portland, OR 97209-2703 | 2020-07-07 |
| 1659996122 | Brooke Bailey | Physical Therapist | 5331 S Macadam Ave Ste 105, Portland, OR 97239-3848 | 2020-06-10 |
| Find all providers in PORTLAND | ||||
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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.