Active NPI
Dumisani Mpofu, PT, DPT
- Physical Therapist
- Benton Harbor, MI
National Provider Identifier
1578064341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501007559
- Practice address
- 2550 Meadowbrook Rd
Benton Harbor, MI 49022-9609 - Phone
- (269) 985-4400
- Fax
- (269) 985-4444
- NPI assigned
- Feb 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 5501007559 | MI | Primary |
Addresses
Primary practice location
2550 Meadowbrook Rd
Benton Harbor, MI 49022-9609
Mailing address
3453 Easy St
Saint Joseph, MI 49085-3744
Phone (269) 429-3552
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501007559 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1578064341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3453 EASY ST",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490853744",
"telephone_number": "269-429-3552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 MEADOWBROOK RD",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490229609",
"telephone_number": "269-985-4400",
"fax_number": "269-985-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MPOFU",
"first_name": "DUMISANI",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501007559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.