Kiran Dornala, PT, DPT, MS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070020721 Issued in IL

Practice address

400 W Russell St
Saline, MI 48176-1183

Phone

(734) 429-1660

Fax

(734) 429-0023

NPI assigned

Aug 28, 2019

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Bay City, MI
  • NPI 1942829064
  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1821646357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RUSSELL ST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W RUSSELL ST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761183",
            "telephone_number": "734-429-1660",
            "fax_number": "734-429-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNALA",
        "first_name": "KIRAN",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David James Diehl, M.D.
• Sharon Kay Dodd Kimmey, M.D.
• Carole Verp Dodge, OTR
• Hannah Katherine Donaldson, MD
• Kristi Donovan
• Carolynn E Dougherty, LPC
• McKenna Gene Drevno
• Jessica Michelle Drews, NP
• Chelsea Kathryn Dumas, PSY.D
• Jeffrey Norman Dzingle, DDS, MS

• Physical Therapist in Saline, MI
• Providers in Saline, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.