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 Specialty Group with one or more individual practitioners, all of who practice with 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 NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1083203400, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
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.
