Kenneth Mynatt, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT013026 Issued in GA

Practice address

1459 Montreal Rd Ste 304
Tucker, GA 30084-6920

Phone

(404) 251-3420

NPI assigned

Jul 29, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1922018423
  Medicare reassignment Care Compare group NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lithonia, GA
  • NPI 1346119831
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Brookhaven, GA
  • NPI 1720097561
  NPD (past)

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

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501286400000",
    "number": "1245754456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD STE 304",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD STE 304",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846920",
            "telephone_number": "404-251-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNATT",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-29",
        "last_updated": "2017-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "PT013026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MSK Healthcare LLC
• Christine Mujica
• Lauren Ashley Murphy
• Kiel James Muserallo, PHARMD
• My Care Inc
• N.D. Lien, P.C.
• N.D. Lien, P.C.
• N.D. Lien, P.C.
• N.D. Lien, P.C.
• N'Perfect Balance, Inc

• Physical Medicine & Rehabilitation Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2017; 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.