Individual provider Active NPI

Dewayne M. Ewing, DPT

  • Physical Therapist
  • Kokomo, IN
National Provider Identifier
1043322365
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05008748A Issued in IN
Practice address
613 W Lincoln Rd
Kokomo, IN 46902-3460
Phone
(765) 416-6630
Fax
(765) 416-6629
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 05008748A IN Primary

Addresses

Primary practice location

613 W Lincoln Rd
Kokomo, IN 46902-3460

Mailing address

33900 Harper Ave Ste 104
Clinton Township, MI 48035-4258
Phone (586) 350-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131230001492 IN Practitioner - Physical Therapist in Private Practice 7416184189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Rehabilitation Services LLC 569 clinicians

Practice addresses (Care Compare)

2302 S Dixon Rd
Suite 150
Kokomo, IN 46902-6427
Phone (765) 416-6630

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05008748AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients

Locations

12955 Old Meridian St
Ste 101
Carmel, IN 46032
Phone (317) 819-6600

9885 E 116th St
Ste 400
Fishers, IN 46037
Phone (317) 682-1872

1992 E Stop 13 Rd
Indianapolis, IN 46227
Phone (317) 808-0230

613 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 319-3522

2302 S Dixon Rd
Ste 150
Kokomo, IN 46902
Phone (317) 453-1205

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1043322365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023460",
            "telephone_number": "765-416-6630",
            "fax_number": "765-416-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "DEWAYNE",
        "middle_name": "M.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008748A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.

Verify at the official NPI Registry.