Active NPI
Kimberly J Jackson Cwynar, PT
- Physical Therapist
- Jackson, MI
National Provider Identifier
1457545113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- KC010406
- Practice address
- 2136 Robinson Rd
Jackson, MI 49203-3557 - Phone
- (517) 750-2540
- NPI assigned
- Sep 5, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | KC010406 | MI | Primary |
Addresses
Primary practice location
2136 Robinson Rd
Jackson, MI 49203-3557
Mailing address
3796 Dibble Rd
Jackson, MI 49201-9344
Phone (517) 937-2022
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 |
|---|---|---|---|
| KC010406 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Rehab Specialists, PC | Physical Therapist | Past | 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.
-
- Physical Therapist
- Jackson, MI
- NPI 1619956646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1457545113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3796 DIBBLE RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019344",
"telephone_number": "517-937-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2136 ROBINSON RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492033557",
"telephone_number": "517-750-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON CWYNAR",
"first_name": "KIMBERLY",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "KC010406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.