Kenneth Lagua Adivino, PT, MS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003604 Issued in WV

Practice address

306 Stanaford Rd
Beckley, WV 25801-3142

Phone

(304) 255-3302

Fax

(304) 254-2783

NPI assigned

Mar 31, 2016

Last updated

Mar 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1184087793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 STANAFORD RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013142",
            "telephone_number": "304-255-3302",
            "fax_number": "304-254-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 STANAFORD RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013142",
            "telephone_number": "304-255-3302",
            "fax_number": "304-254-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADIVINO",
        "first_name": "KENNETH",
        "middle_name": "LAGUA",
        "name_prefix": "Mr.",
        "credential": "PT, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003604",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Adams
• Sarah Adams
• Tara Faith Adams, FNP
• Bryna Marla Addair
• Trevor J. Addison, PTA
• Adrianna Adkins
• Bobbie Adkins
• Carmelina Adkins
• Chanda Danielle Adkins, PHARM D.
• Clifton Adkins Jr., LPC

• Physical Therapist in Beckley, WV
• Providers in Beckley, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.