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

Kyle Niswonger

Individual provider Athletic Trainer · NPI 1215329826

Kyle Niswonger is a Physical Therapist in Private Practice in Holland, Michigan. Qualified in 2022, 4 years ago. Practices with Ivyrehab Michigan LLC, a 155-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2015
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Practice location Address checks out

141 E 12th St
Holland, MI 49423-3607
Phone: (248) 804-7447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1215329826
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 19, 2015
Last updated in NPPESMay 25, 2017
Mailing address2385 Millbrook Ct, Rochester Hills, MI 48306-3144

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ivyrehab Michigan Llc — 155 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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