Individual provider Active NPI

Natesan Kannanpillai, PHYSICAL THERAPIST

  • Physical Therapist
  • Southfield, MI
National Provider Identifier
1285970400
Registry record updated Dec 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501008299 Issued in MI
Practice address
21415 Civic Center Dr
Suite # 115
Southfield, MI 48076-3909
Phone
(248) 327-6266
NPI assigned
Dec 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2012

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 5501008299 MI Primary

Addresses

Primary practice location

21415 Civic Center Dr
Suite # 115
Southfield, MI 48076-3909

Mailing address

21415 Civic Center Dr
Suite # 115
Southfield, MI 48076-3909
Phone (248) 327-6266

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1355529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355529600000",
    "number": "1285970400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21415 CIVIC CENTER DR",
            "address_2": "SUITE # 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763909",
            "telephone_number": "248-327-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21415 CIVIC CENTER DR",
            "address_2": "SUITE # 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763909",
            "telephone_number": "248-327-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNANPILLAI",
        "first_name": "NATESAN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-15",
        "last_updated": "2012-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2012; 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.