Individual provider Active NPI

Jihan Elise El-Kurdi, PTA

  • Physical Therapy Assistant
  • Southfield, MI
National Provider Identifier
1689184202
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502005146 Issued in MI
Practice address
29201 Telegraph Rd
Southfield, MI 48034-1331
Phone
(248) 304-7776
Fax
(248) 918-2024
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502005146 MI Primary

Addresses

Primary practice location

29201 Telegraph Rd
Southfield, MI 48034-1331

Mailing address

29201 Telegraph Rd
Southfield, MI 48034-1331
Phone (248) 304-7776

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

LicenseStateTypeSpecialty
5502005146MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1689184202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-304-7776",
            "fax_number": "248-918-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-304-7776",
            "fax_number": "248-918-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-KURDI",
        "first_name": "JIHAN",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.