Individual provider Active NPI

Kanwaldeep Kaur Kapoor

  • Physical Therapist
  • Midland, MI
National Provider Identifier
1023510617
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013401 Issued in MI
Practice address
4401 Campus Ridge Dr Ste 1000
Midland, MI 48640-6125
Phone
(989) 837-9100
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501013401 MI Primary

Addresses

Primary practice location

4401 Campus Ridge Dr Ste 1000
Midland, MI 48640-6125

Mailing address

4325 Windemere Dr
Saginaw, MI 48603-1271
Phone (269) 924-6148

Other practice location 1

4851 E Pickard St Ste 2600
Mount Pleasant, MI 48858-2042
Phone (989) 775-1662

Other identifiers 1

IdentifierTypeStateIssuer
1003817321MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501013401MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1023510617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 WINDEMERE DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031271",
            "telephone_number": "269-924-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE 1000",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406125",
            "telephone_number": "989-837-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4851 E Pickard St Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "MI",
            "postal_code": "488582042",
            "country_code": "US",
            "telephone_number": "989-775-1662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPOOR",
        "first_name": "KANWALDEEP KAUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003817321",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.