Active NPI
Premanand Karunamurthy, DPT
- Physical Therapist
- Rockford, IL
National Provider Identifier
1326359852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.017570
- Practice address
- 735 Highgrove PL
Rockford, IL 61108-2520 - Phone
- (815) 226-4365
- Fax
- (815) 226-4589
- NPI assigned
- Jun 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 008593 | CT | |
| Physical Therapist | 225100000X | 070.017570 | IL | Primary |
Addresses
Primary practice location
735 Highgrove PL
Rockford, IL 61108-2520
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206
Other practice location 1
3201, West Commercial Blvd.,
Suite#116 Medpro
Fort Lauderdale, FL 33309-0000
Phone (954) 332-4445
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 |
|---|---|---|---|
| 008593 | CT | MD | Clinical Social Worker |
| 070.017570 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morsay Physical Medicine Center LTD. | Past | Accepting new patients | |
| Medpro | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Rockford, IL
- NPI 1952311706
-
- Physical Therapist
- Fort Lauderdale, FL
- NPI 1033353339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1326359852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "866-370-8206",
"fax_number": "517-435-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 HIGHGROVE PL",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082520",
"telephone_number": "815-226-4365",
"fax_number": "815-226-4589"
}
],
"practiceLocations": [
{
"address_1": "3201, West Commercial Blvd.,",
"address_2": "Suite#116 Medpro",
"address_purpose": "LOCATION",
"city": "Fort Lauderdale",
"state": "FL",
"postal_code": "333090000",
"country_code": "US",
"telephone_number": "954-332-4445",
"fax_number": "866-422-6431",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KARUNAMURTHY",
"first_name": "PREMANAND",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-30",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "008593",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.017570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.