KELLY GOTBERG (NPI# 1265916852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265916852 |
| Entity Type | Individual |
| Full Name | KELLY GOTBERG |
| Other Name | KELLY NEMETH |
| Credential | PT, DPT |
| Practice Address |
854 Washington Ave Ste 200 Holland MI 49423-7143 |
| Mailing Address |
5380 Lake Michigan Dr Allendale MI 49401-9484 |
| Practice Telephone | 6163929430 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
5501018868 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
854 WASHINGTON AVE STE 200 |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-7143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996714 | Ella Rose Marx | Social Worker | 412 Century Lane, Holland, MI 49423 | 2019-08-02 |
| 1245720424 | Amanda Ann Allen | Behavior Technician | 165 Sorrento Drive, Holland, MI 49423 | 2018-05-14 |
| 1588194237 | Emily Amila Geurink | Physical Therapy Assistant | 4037 43rd St, Holland, MI 49423 | 2017-06-15 |
| 1285081737 | Kara Draayer | Nurse Anesthetist, Certified Registered | 25 W 8th St Ste 200, Holland, MI 49423 | 2016-05-14 |
| 1851776413 | Sara Ty | Occupational Therapist | 789 South Meadow Court, Holland, MI 49423 | 2015-07-24 |
| 1508243056 | Andrew Peasley | Chiropractor | 436 Century Ln., Holland, MI 49423 | 2015-05-05 |
| 1437536497 | Deborah Donnelly | Physical Therapy Assistant | 1221 16th Street, Holland, MI 49423 | 2015-04-29 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1003257817 | Courtney Young | Social Worker | 96 W 15 Street Midtown Center- Arbor Circle, Holland, MI 49423 | 2013-07-09 |
| 1689014391 | Jason Pettet | Acupuncturist | 500 West 17th St., Holland, MI 49423 | 2013-06-26 |
| Find all providers in zip 49423 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720457328 | Lana Frody | Physical Therapist | 11595 E Lakewood Blvd Ste 80, Holland, MI 49424-8695 | 2015-09-24 |
| 1871095448 | Lynda T Miller | Physical Therapist | 335 120th Ave, Holland, MI 49424-2118 | 2018-02-28 |
| 1023385192 | Nathan Edward Dykema | Physical Therapist | 730 Chicago Dr, Holland, MI 49423-3004 | 2011-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851514 | Rebecca Marie Beery | Physical Therapist | 9551 Saline Waterworks Rd, Manchester, MI 48158-9728 | 2020-11-05 |
| 1861037921 | Jackson Hanks II | Physical Therapist | 2901 Commerce Xing, Commerce Township, MI 48390-3084 | 2019-11-13 |
| 1366084030 | Shelby Gusfa | Physical Therapist | 36622 Five Mile Rd Ste 102, Livonia, MI 48154-1900 | 2019-10-14 |
| 1881168078 | Jessie Lynn Lewis | Physical Therapist | 3315 E Michigan Ave Ste 4, Lansing, MI 48912-4649 | 2019-01-22 |
| 1063980373 | Fuel Physical Therapy & Sports Performance, LLC | Physical Therapist | 1139 Houseman Ave Ne, Grand Rapids, MI 49503-1229 | 2018-11-05 |
| 1386111243 | Your Alternative Pt, LLC | Physical Therapist | 640 Romence Rd Ste 111, Portage, MI 49024-3400 | 2018-10-30 |
| 1811472319 | Rachel E Michalski | Physical Therapist | 12150 30 Mile Rd Ste 102, Washington Township, MI 48095-2035 | 2018-10-01 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1790272078 | Susan G Gall | Physical Therapist | 67267 S Main St, Richmond, MI 48062-1919 | 2018-04-22 |
| 1508368903 | John Paul Guidarelli | Physical Therapist | St. Mary's of Michigan, 9900 Birch Run Road, Birch Run, MI 48415 | 2018-03-02 |
| Find all providers with the same taxonomy | ||||
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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.