Active NPI
Kenneth Lee Flinchum, DPT
- Physical Therapist
- Mocksville, NC
National Provider Identifier
1235656778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17373
- Practice address
- 215 Cemetery St
Mocksville, NC 27028-2103 - Phone
- (336) 893-2550
- Fax
- (336) 751-0030
- NPI assigned
- Aug 25, 2017
- Sex
- Male
- 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 | 17373 | NC | Primary |
Addresses
Primary practice location
215 Cemetery St
Mocksville, NC 27028-2103
Mailing address
PO Box 601791
Charlotte, NC 28260-1791
Other practice location 1
190 Kimel Park Dr Ste 139
Winston Salem, NC 27103-6946
Phone (336) 718-6931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17373 | Other | NC | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kflinchum677813@direct.novanthealth.org |
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)
- Not enrolled
Interoperability endpoints
- kflinchum677813@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1235656778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601791",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 CEMETERY ST",
"city": "MOCKSVILLE",
"state": "NC",
"postal_code": "270282103",
"telephone_number": "336-893-2550",
"fax_number": "336-751-0030"
}
],
"practiceLocations": [
{
"address_1": "190 Kimel Park Dr Ste 139",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271036946",
"country_code": "US",
"telephone_number": "336-718-6931",
"fax_number": "336-718-3389",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLINCHUM",
"first_name": "KENNETH",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-25",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "17373",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "17373",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kflinchum677813@direct.novanthealth.org",
"affiliation": "N",
"address_1": "190 Kimel Park Dr Ste 139",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271036946",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mocksville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.