Active NPI
Sumithra Rajendran
- Physical Therapist
- Pleasant Prairie, WI
National Provider Identifier
1104318096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14136-24
- Practice address
- 9651 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1948 - Phone
- (262) 333-8158
- NPI assigned
- Jun 5, 2018
- Last updated
- Jun 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14136-24 | WI | Primary |
Addresses
Primary practice location
9651 Prairie Ridge Blvd
Pleasant Prairie, WI 53158-1948
Mailing address
223 Litchfield CT
Grayslake, IL 60030-3705
Phone (224) 795-2577
Other practice location 1
8351 Sheridan Rd
Kenosha, WI 53143-6339
Phone (262) 948-1100
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14136-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528156800000",
"number": "1104318096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 LITCHFIELD CT",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600303705",
"telephone_number": "224-795-2577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9651 PRAIRIE RIDGE BLVD",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531581948",
"telephone_number": "262-333-8158"
}
],
"practiceLocations": [
{
"address_1": "8351 Sheridan Rd",
"address_purpose": "LOCATION",
"city": "Kenosha",
"state": "WI",
"postal_code": "531436339",
"country_code": "US",
"telephone_number": "262-948-1100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAJENDRAN",
"first_name": "SUMITHRA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2018-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14136-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.