Individual provider Active NPI

David Kirubakaran

  • Physical Therapist
  • Kokomo, IN
National Provider Identifier
1952904328
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05003031A Issued in IN
Practice address
606 Philadelphia Dr
Kokomo, IN 46902-4920
Phone
(765) 437-4724
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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 05003031A IN Primary

Addresses

Primary practice location

606 Philadelphia Dr
Kokomo, IN 46902-4920

Mailing address

606 Philadelphia Dr
Kokomo, IN 46902-4920
Phone (765) 437-4724

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
05003031AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1952904328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 PHILADELPHIA DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024920",
            "telephone_number": "765-437-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 PHILADELPHIA DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469024920",
            "telephone_number": "765-437-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRUBAKARAN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05003031A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.