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 provides Pediatrics Physician services 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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