Active NPI
Nathan Keniston, DPT
- Physical Therapist
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501017367
- Practice address
- 5886 Venture Park Dr
Kalamazoo, MI 49009-1848 - Phone
- (269) 375-4737
- NPI assigned
- Sep 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 63210 | OR | |
| Physical Therapist | 225100000X | 5501017367 | MI | Primary |
| Physical Therapist | 225100000X | 070022218 | IL |
Addresses
Primary practice location
5886 Venture Park Dr
Kalamazoo, MI 49009-1848
Mailing address
6809 Amberly St
Portage, MI 49024-3108
Phone (541) 821-1763
Other practice location 1
2780 E Barnett Rd Ste 200
Medford, OR 97504
Phone (541) 779-6250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
710 N Ave
Armor Physical Therapy
Battle Creek, MI 49017-3258
Phone (269) 788-3040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physical Therapy Group LLC | Physical Therapist | Current | Accepting new patients |
Locations
710 North Ave
Battle Creek, MI 49017
Phone (269) 704-3133
607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398
601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284
5886 Venture Park Dr
Kalamazoo, MI 49009
Phone (269) 375-4737
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Holland, MI
- NPI 1649216144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1013385806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6809 AMBERLY ST",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490243108",
"telephone_number": "541-821-1763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5886 VENTURE PARK DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490091848",
"telephone_number": "269-375-4737"
}
],
"practiceLocations": [
{
"address_1": "2780 E Barnett Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "97504",
"country_code": "US",
"telephone_number": "541-779-6250",
"fax_number": "541-772-2531",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENISTON",
"first_name": "NATHAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-10",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "63210",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017367",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070022218",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.