Active NPI
Khatija Punjwani, PT
- Physical Therapist
- Kenosha, WI
National Provider Identifier
1992306005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15029-24
- Practice address
- 8351 Sheridan Rd
Kenosha, WI 53143-6339 - Phone
- (847) 481-9228
- NPI assigned
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15029-24 | WI | Primary |
Addresses
Primary practice location
8351 Sheridan Rd
Kenosha, WI 53143-6339
Mailing address
548 Leamington Ave
Wilmette, IL 60091-2056
Phone (847) 481-9228
Other practice location 1
103 N Dodge St
Burlington, WI 53105-1918
Phone (847) 481-9228
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15029-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1992306005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "548 LEAMINGTON AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912056",
"telephone_number": "847-481-9228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8351 SHERIDAN RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531436339",
"telephone_number": "847-481-9228"
}
],
"practiceLocations": [
{
"address_1": "103 N Dodge St",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "WI",
"postal_code": "531051918",
"country_code": "US",
"telephone_number": "847-481-9228",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PUNJWANI",
"first_name": "KHATIJA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "15029-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.