Active NPI
Renu Joseph
- Physical Therapist
- Portage, MI
National Provider Identifier
1619354495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501013545
- Practice address
- 7855 Currier Dr
Portage, MI 49002-4314 - Phone
- (269) 323-7748
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 5501013545 | MI | Primary |
Addresses
Primary practice location
7855 Currier Dr
Portage, MI 49002-4314
Mailing address
5788 Attleberry Ave
Kalamazoo, MI 49009-4116
Phone (630) 234-6151
Other names 1
- Renu Jacob
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1619354495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5788 ATTLEBERRY AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490094116",
"telephone_number": "630-234-6151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7855 CURRIER DR",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490024314",
"telephone_number": "269-323-7748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "RENU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501013545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENU",
"last_name": "JACOB",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.