Individual provider Active NPI

Viswanathan Venkataswamy, P.T.

  • Physical Therapist
  • Detroit, MI
National Provider Identifier
1912039900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007322 Issued in MI
Practice address
5407 Michigan Ave
Detroit, MI 48210-3033
Phone
(313) 894-4106
Fax
(313) 894-7374
NPI assigned
Mar 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5501007322 MI Primary

Addresses

Primary practice location

5407 Michigan Ave
Detroit, MI 48210-3033

Mailing address

28105 Declaration Rd
Novi, MI 48377-2546
Phone (248) 449-7281

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rafa Therapies Inc Physical Therapist CurrentSince Oct 9, 2022 Accepting new patients
Universal Physical Therapy Services, P.C. Physical Therapist Past Accepting new patients
Wesley Assoc Inc Past Accepting new patients

Locations

4745 Michigan Ave
Detroit, MI 48210
Phone (313) 442-7875

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912039900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28105 DECLARATION RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772546",
            "telephone_number": "248-449-7281",
            "fax_number": "313-894-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103033",
            "telephone_number": "313-894-4106",
            "fax_number": "313-894-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATASWAMY",
        "first_name": "VISWANATHAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.