Individual provider Active NPI

Rob E. Kennell, MPT

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1184710873
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007246 Issued in WA
Practice address
2620 S Williams PL
Ste 110
Kennewick, WA 99338-1867
Phone
(509) 737-0333
Fax
(509) 737-0355
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 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 PT00007246 WA Primary

Addresses

Primary practice location

2620 S Williams PL
Ste 110
Kennewick, WA 99338-1867

Mailing address

2620 S Williams PL
Ste 110
Kennewick, WA 99338-1867
Phone (509) 737-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000033 WA Practitioner - Physical Therapist in Private Practice 7517921810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Rivers Physical Therapy PCGroup PAC ID 1355305657, 3 clinicians

Practice addresses (Care Compare)

2620 S Williams PL
Suite 110
Kennewick, WA 99338-1867
Phone (509) 737-0333

2620 S Williams PL
Suite 110
Kennewick, WA 99338-2908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00007246WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Physical Therapy PC Physical Therapist CurrentSince Apr 1, 2005 Accepting new patients

Locations

2620 S Williams Pl
Ste 110
Kennewick, WA 99338
Phone (509) 349-3010

4309 W 27th Pl
Ste 201
Kennewick, WA 99338
Phone (509) 737-0333

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1184710873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 S WILLIAMS PL",
            "address_2": "STE 110",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381867",
            "telephone_number": "509-737-0333",
            "fax_number": "509-737-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S WILLIAMS PL",
            "address_2": "STE 110",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381867",
            "telephone_number": "509-737-0333",
            "fax_number": "509-737-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELL",
        "first_name": "ROB",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.