Active NPI
Kenneth Koolwick
- Massage Therapist
- Plymouth, MI
National Provider Identifier
1396551008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 15175 N Sheldon Rd
Plymouth, MI 48170-2483 - Phone
- (734) 207-1400
- NPI assigned
- Dec 6, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
15175 N Sheldon Rd
Plymouth, MI 48170-2483
Mailing address
9545 Steephollow Dr
White Lake, MI 48386-2370
Phone (248) 640-7369
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Relaxing Rituals, LLC | Massage Therapist | Current | Accepting new patients |
Locations
15175 N Sheldon Rd
Plymouth, MI 48170
Phone (734) 207-1400
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.
-
dba Hand & Stone Massage and Facial Spa
- Massage Therapist
- Plymouth, MI
- NPI 1821804535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1396551008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9545 STEEPHOLLOW DR",
"city": "WHITE LAKE",
"state": "MI",
"postal_code": "483862370",
"telephone_number": "248-640-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15175 N SHELDON RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481702483",
"telephone_number": "734-207-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOLWICK",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-06",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.