Individual provider Active NPI

Jon Paul Van Kempen, PT

  • Physical Therapist
  • Rensselaer, NY
National Provider Identifier
1093996928
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029685 Issued in NY
Practice address
1 Agway Dr
Rensselaer, NY 12144-9637
Phone
(518) 326-9065
Fax
(518) 326-9064
NPI assigned
Nov 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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 029685 NY Primary

Addresses

Primary practice location

1 Agway Dr
Rensselaer, NY 12144-9637

Mailing address

1 Agway Dr
Rensselaer, NY 12144-9637
Phone (518) 326-9065

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
Community Care Physicians, PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1093996928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AGWAY DR",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449637",
            "telephone_number": "518-326-9065",
            "fax_number": "518-326-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AGWAY DR",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449637",
            "telephone_number": "518-326-9065",
            "fax_number": "518-326-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KEMPEN",
        "first_name": "JON",
        "middle_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.