Individual provider Active NPI

Kamal Kishore Kashyap, RPT

  • Physical Therapist
  • Gladwin, MI
National Provider Identifier
1861518508
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005372 Issued in MI
Practice address
3200 Pratt Lake Rd
Gladwin, MI 48624-8901
Phone
(989) 488-4569
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501005372 MI Primary

Addresses

Primary practice location

3200 Pratt Lake Rd
Gladwin, MI 48624-8901

Mailing address

3200 Pratt Lake Rd
Gladwin, MI 48624-8901
Phone (989) 488-4569

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1861518508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PRATT LAKE RD",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486248901",
            "telephone_number": "989-488-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PRATT LAKE RD",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486248901",
            "telephone_number": "989-488-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHYAP",
        "first_name": "KAMAL",
        "middle_name": "KISHORE",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.