Individual provider Active NPI

Adoniah Mavura Mukona

  • Physical Therapist
  • Avon, IN
National Provider Identifier
1588859631
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05004874A Issued in IN
Practice address
1801 Red Phister Dr
Avon, IN 46123-7172
Phone
(317) 272-1383
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05004874A IN Primary
Physical Therapist 225100000X

Addresses

Primary practice location

1801 Red Phister Dr
Avon, IN 46123-7172

Mailing address

1801 Red Phister Dr
Avon, IN 46123-7172
Phone (317) 272-1383

Other names 1

  • Mr. Adoniah Mavura Mukona Professional name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Careers International LLC. 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.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1588859631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 RED PHISTER DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237172",
            "telephone_number": "317-272-1383",
            "fax_number": "317-272-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 RED PHISTER DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237172",
            "telephone_number": "317-272-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKONA",
        "first_name": "ADONIAH",
        "middle_name": "MAVURA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004874A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADONIAH",
            "last_name": "MUKONA",
            "middle_name": "MAVURA",
            "prefix": "MR.",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.