Active NPI
Rajesh Kuppusamy, PHYSICAL THERAPIST
- Specialist
- Whitmore Lake, MI
National Provider Identifier
1578702502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5501008776
- Practice address
- 11293 Terrace View Dr
Whitmore Lake, MI 48189-9126 - Phone
- (810) 623-9535
- Fax
- (810) 231-1198
- NPI assigned
- Feb 15, 2009
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 5501008776 | MI | Primary |
Addresses
Primary practice location
11293 Terrace View Dr
Whitmore Lake, MI 48189-9126
Mailing address
11293 Terrace View Dr
Whitmore Lake, MI 48189-9126
Phone (810) 623-9535
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 |
|---|---|---|---|
| 5501008776 | MI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234656000000",
"number": "1578702502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11293 TERRACE VIEW DR",
"city": "WHITMORE LAKE",
"state": "MI",
"postal_code": "481899126",
"telephone_number": "810-623-9535",
"fax_number": "810-231-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11293 TERRACE VIEW DR",
"city": "WHITMORE LAKE",
"state": "MI",
"postal_code": "481899126",
"telephone_number": "810-623-9535",
"fax_number": "810-231-1198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPPUSAMY",
"first_name": "RAJESH",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-15",
"last_updated": "2009-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "5501008776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitmore Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.