Individual provider Active NPI

Kelvin P Onwuemene

  • Physical Therapy Assistant
  • Livonia, MI
National Provider Identifier
1821740168
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2165652 Issued in TX
Practice address
16310 Bell Creek LN
Livonia, MI 48154-2937
Phone
(734) 674-1720
NPI assigned
Jan 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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 2165652 TX Primary

Addresses

Primary practice location

16310 Bell Creek LN
Livonia, MI 48154-2937

Mailing address

16310 Bell Creek LN
Livonia, MI 48154-2937
Phone (734) 674-1720

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
2165652TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1821740168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16310 BELL CREEK LN",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542937",
            "telephone_number": "734-674-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16310 BELL CREEK LN",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542937",
            "telephone_number": "734-674-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONWUEMENE",
        "first_name": "KELVIN",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2165652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.