Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grand River Rehabilitation LLC

Organization Pediatrics Physician · NPI 1124519707

Grand River Rehabilitation LLC is a Pediatrics Physician in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2018.

Licensed in
MI
In the registry since
2018
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone: (616) 780-2324
Fax: (877) 991-4975
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 4301091218 (MI)
Pediatrics Physician Taxonomy 208000000X · Licence 4301091218 (MI)
Pediatric Rehabilitation Medicine Physician Taxonomy 2081P0010X · Licence 4301091218 (MI)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X

Record details

NPI number1124519707
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adam Rush — Owner · (616) 780-7389
NPI enumeratedMay 19, 2018
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023
Mailing address412 Plymouth Ave Ne, Grand Rapids, MI 49505-6028

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