Individual provider Active NPI

Kevin Hargrow, PTA

  • Physical Therapy Assistant
  • Ypsilanti, MI
National Provider Identifier
1376330381
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502008636 Issued in MI
Practice address
1449 Rue Deauville Blvd
Ypsilanti, MI 48198-7551
Phone
(734) 353-0356
NPI assigned
Apr 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502008636 MI Primary

Addresses

Primary practice location

1449 Rue Deauville Blvd
Ypsilanti, MI 48198-7551

Mailing address

1449 Rue Deauville Blvd
Ypsilanti, MI 48198-7551
Phone (734) 353-0356

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

State licenses

LicenseStateTypeSpecialty
5502008636MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1376330381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 RUE DEAUVILLE BLVD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987551",
            "telephone_number": "734-353-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 RUE DEAUVILLE BLVD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987551",
            "telephone_number": "734-353-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROW",
        "first_name": "KEVIN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502008636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.