Jeevananthan Koodalingam, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008148 Issued in MI

Practice address

28328 Clymer Dr
Novi, MI 48377-2588

Phone

(248) 763-9369

NPI assigned

Jul 27, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1487576104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28328 CLYMER DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772588",
            "telephone_number": "248-763-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28328 CLYMER DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772588",
            "telephone_number": "248-763-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOODALINGAM",
        "first_name": "JEEVANANTHAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalyn Kollie
• Amy L Komperda, NP
• Darryl Francis Kompus, DPM
• Lindsay Konal, OTR
• Jeffrey Kong, LMT, CFST
• Lauri Ann Kopchia
• Kimberly Kopeck
• Patrick Kopek
• Brooke Marie Koran
• Nicole Korbinski

• Physical Therapist in Novi, MI
• Providers in Novi, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.