Boone S. Kowalis Sr.

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Practice address

15752 Oakhill CT
Livonia, MI 48154-2613

Phone

(800) 447-6038

Fax

(734) 542-4289

NPI assigned

Oct 29, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Innovative Concepts

  • Durable Medical Equipment & Medical Supplies
  • Livonia, MI
  • NPI 1215149489
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1023297884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15752 OAKHILL CT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542613",
            "telephone_number": "800-447-6038",
            "fax_number": "734-542-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15752 OAKHILL CT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542613",
            "telephone_number": "800-447-6038",
            "fax_number": "734-542-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALIS",
        "first_name": "BOONE",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0323939",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4431900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael L Kostreva, IONM TECH
• Jimmy Bhadresh Kumar Kotak, PTA
• Katrina Grace Kotcher, LMSW, CAADC
• Teja Kotipalli
• Kelly Michelle Kovach-Collicott, LMSW, ACSW
• Dawnmarie Kozlowski, OTR/L
• Walter John Kozlowski, RPH
• Barbara Kozyn, PT
• Lindsey Krajewski, MOT, OTR/L
• Kramer Chiropractic PC

• Home Modifications Contractor in Livonia, MI
• Providers in Livonia, MI by specialty
• Home Modifications Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.