Individual provider Active NPI

Jonathan Paul Slater, PT, DPT

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1184950248
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014868 Issued in MI
Practice address
6120 Stadium Dr
Kalamazoo, MI 49009-3022
Phone
(269) 372-8555
NPI assigned
Oct 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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 5501014868 MI Primary

Addresses

Primary practice location

6120 Stadium Dr
Kalamazoo, MI 49009-3022

Mailing address

5836 S 4TH St
Kalamazoo, MI 49009-8435
Phone (269) 744-0232

Other practice location 1

6016 Lovers Ln
Ste 3
Portage, MI 49002-3050
Phone (269) 329-0934

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

LicenseStateTypeSpecialty
5501014868MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy Group LLC Physical Therapist PastSince Nov 11, 2010 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1184950248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5836 S 4TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098435",
            "telephone_number": "269-744-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093022",
            "telephone_number": "269-372-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6016 Lovers Ln",
            "address_2": "Ste 3",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490023050",
            "country_code": "US",
            "telephone_number": "269-329-0934",
            "fax_number": "269-329-0965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATER",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014868",
            "primary": true
        }
    ],
    "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 Dec 11, 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.

Verify at the official NPI Registry.