NPIMap

Organization Active NPI

Kiwi PT, LLC

  • Physical Therapist
  • Highland, MI
National Provider Identifier
1861927287
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005651 Issued in MI
Legal business name
KIWI PT, LLC
Practice address
2330 S Milford Rd
Suite 108
Highland, MI 48357-4982
Phone
(248) 949-5128
NPI assigned
Apr 24, 2017
Last updated
Apr 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Bruce WihongiNPI 1538290762
Title
Owner
Phone
(248) 949-5128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501005651 MI Primary

Addresses

Primary practice location

2330 S Milford Rd
Suite 108
Highland, MI 48357-4982

Mailing address

2330 S Milford Rd
Suite 108
Highland, MI 48357-4982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170525002381 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921375775 Receives reassigned benefits from 7 practitioners
Practice locations: Highland, MI

National Provider Directory

National Provider Directory

Locations

2330 S Milford Rd
Ste 108
Highland, MI 48357
Phone (248) 387-5494

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1861927287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S MILFORD RD",
            "address_2": "SUITE 108",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S MILFORD RD",
            "address_2": "SUITE 108",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574982",
            "telephone_number": "248-949-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIWI PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "WIHONGI",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-949-5128"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.