Individual provider Active NPI

Kenneth Allen Lynnes, DPT

  • Orthopedic Physical Therapist
  • Cary, NC
National Provider Identifier
1235408634
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
P13521 Issued in NC
Practice address
1120 SE Cary Pkwy
Suite 100
Cary, NC 27518-7413
Phone
(919) 467-7801
Fax
(919) 297-0000
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X P13521 NC Primary

Addresses

Primary practice location

1120 SE Cary Pkwy
Suite 100
Cary, NC 27518-7413

Mailing address

1120 SE Cary Pkwy
Suite 100
Cary, NC 27518-7413
Phone (919) 467-7801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000299 NC Practitioner - Physical Therapist in Private Practice 7911174123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, 540 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

10205 US Hwy 15-510
Suite 24
Southern Pines, NC 28387
Phone (910) 704-5430

2605 Blue Ridge Rd
Suite 230
Raleigh, NC 27607-6475
Phone (919) 781-1637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13521NCMDDentist
P13521NCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy of North Carolina Inc CurrentSince Mar 1, 2022 Accepting new patients
Proactive Therapy of North Carolina Inc Current Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Oct 1, 2024 Accepting new patients
Proactive Therapy of North Carolina Inc CurrentSince Mar 1, 2022 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Oct 1, 2024 Accepting new patients
Cary Orthopaedic and Sports Medicine Specialists, P.a. Past Accepting new patients

Locations

10020 Edison Square Dr NW
Ste C105
Concord, NC 28027
Phone (704) 948-5351

2605 Blue Ridge Rd
Ste 230
Raleigh, NC 27607
Phone (919) 781-1637

2358 US Highway 70
Ste Ab
Swannanoa, NC 28778
Phone (828) 686-3375

Organizations & group practices 6

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": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1235408634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 SE CARY PKWY",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187413",
            "telephone_number": "919-467-7801",
            "fax_number": "919-297-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SE CARY PKWY",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187413",
            "telephone_number": "919-467-7801",
            "fax_number": "919-297-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNNES",
        "first_name": "KENNETH",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P13521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.