Kensington Valley Orthotic & Sports Services

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

KENSINGTON VALLEY ORTHOTIC & SPORTS SERVICES

Practice address

10020 Professional Canter Dr.
Hamburg, MI 48139-0215

Phone

(810) 231-6905

Fax

(810) 231-6906

NPI assigned

Feb 21, 2006

Organization subpart

No

Name

Mr. Daniel Quentin Minert, C.O.NPI 1306811765

Title

President/Owner

Phone

(810) 231-6905

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Quentin Minert, C. O.

  • Orthotist
  • Hamburg, MI
  • NPI 1306811765
  NPD (past) Authorized official
• Rodney P. Goble, MPT

  • Physical Therapist
  • Brighton, MI
  • NPI 1063405462
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 13, 2011.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1528033909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "481390215",
            "telephone_number": "810-231-6905",
            "fax_number": "801-231-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 PROFESSIONAL CANTER DR.",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "481390215",
            "telephone_number": "810-231-6905",
            "fax_number": "810-231-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON VALLEY ORTHOTIC & SPORTS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "MINERT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "QUENTIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "810-231-6905",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4489299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "510D703120",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura B Hagan, OT
• Danelle Hale, DPT
• Elizabeth Anne Howell, PT
• Iha Health Services Corporation
• Alyssa Kelsey, PT
• Jacquelin Kay Kilburn, OT
• Luci H. Klinkhamer, CCC-SLP
• Matthew Koziol, DPT
• Livingston Eyecare Associates, LLC
• Amanda McClain

• All providers in Hamburg, MI
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.