Active NPI
Kenyon Elizabeth Grant, PT
- Physical Therapist
- Murrieta, CA
National Provider Identifier
1245390640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT24443
- Practice address
- 25285 Madison Ave Ste 102
Murrieta, CA 92562-8955 - Phone
- (951) 600-0054
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- 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 | PT24443 | CA | Primary |
Addresses
Primary practice location
25285 Madison Ave Ste 102
Murrieta, CA 92562-8955
Mailing address
1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748
Phone (949) 679-3988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT24443 | Other | CA | PT LICENSE |
Other names 1
- Miss Kenyon Elizabeth Krause
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JM Physical Therapy Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Geriatric Physical Therapist
- Laguna Niguel, CA
- NPI 1821104472
-
- Home Health Agency
- Irvine, CA
- NPI 1659543957
-
- Physical Therapist
- Laguna Niguel, CA
- NPI 1558658336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634256000000",
"number": "1245390640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PETERS CANYON RD STE 120",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061748",
"telephone_number": "949-679-3988",
"fax_number": "562-431-9854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25285 MADISON AVE STE 102",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925628955",
"telephone_number": "951-600-0054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "KENYON",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2021-10-15",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT24443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PT24443",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KENYON",
"last_name": "KRAUSE",
"middle_name": "ELIZABETH",
"prefix": "MISS",
"credential": "PT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.