GRAND RAPIDS PHYSICAL THERAPY & PERFORMANCE
NPI 1083203400
Physical Therapist - Sports in Grand Rapids, MI
NPI Status: Active since January 11, 2021
Contact Information
1236 PLYMOUTH AVE NE
GRAND RAPIDS, MI
ZIP 49505
Phone: (989) 780-2748
- Organization
- Physical Therapist
- Sports
- CLIA Number: 23D0942683
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 03-15-2026
About GRAND RAPIDS PHYSICAL THERAPY & PERFORMANCE
This page provides the complete NPI Profile along with additional information for Grand Rapids Physical Therapy & Performance, a provider established in Grand Rapids, Michigan operating as a Physical Therapist, focusing in sports . The healthcare provider is registered in the NPI registry with number 1083203400 assigned on January 2021. The practitioner's primary taxonomy code is 2251S0007X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Joseph Hanisko Dpt (Owner/pt)
- NPI
- 1083203400
- Provider Name
- GRAND RAPIDS PHYSICAL THERAPY & PERFORMANCE
- Entity Type
- Organization
- Location Address
- 1236 PLYMOUTH AVE NE GRAND RAPIDS, MI 49505
- Location Phone
- (989) 780-2748
- Mailing Address
- 1236 PLYMOUTH AVE NE GRAND RAPIDS, MI 49505
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-11-2021
- Last Update Date
- 01-11-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Therapist Sports
- Taxonomy Code
- 2251S0007X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy Description
- A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0942683
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- March 16, 2024
- Certificate Expiration Date
- March 15, 2026
- Laboratory Director
- TRACEY D. NELSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Grand Rapids Physical Therapy & Performance to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 8 | 3 | 2 | 0 | 3 | 4 | 0 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 16 | 3 | 4 | 0 | 6 | 4 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 6 + 3 + 4 + 0 + 6 + 4 + 0 + 24 = 50 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1083203400 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083203400, enumerated as an "organization" on January 11, 2021.
The provider is located at 1236 PLYMOUTH AVE NE GRAND RAPIDS, MI 49505 and the phone number is (989) 780-2748.
Physical Therapist with taxonomy code 2251S0007X and a focus in Sports.
