Jennifer Lyn Kanieski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3863 Issued in NM

Practice address

10301 Golf Course Rd NW
Albuquerque, NM 87114-5380

Phone

(928) 460-3599

NPI assigned

Jun 2, 2009

Last updated

Jul 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Jennifer Lyn Robinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)
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  • General Acute Care Hospital
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  • NPI 1831112358
  NPD (past)

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1255567434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 GOLF COURSE RD NW # D3-178",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205842",
            "telephone_number": "928-460-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145380",
            "telephone_number": "928-460-3599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19875 SW 65th Ave Ste 255",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970628353",
            "country_code": "US",
            "telephone_number": "503-692-2657",
            "fax_number": "503-692-7730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANIESKI",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4499",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "3863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO BOARD OF PHYSICAL THERAPY",
            "identifier": "3863",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "4499",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROBINSON",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Whitney Kane, LISW
• Kaimana Burk Moiha Kanekoa
• David Kaneshiro
• Chunwoo Kang, DDS
• Caitya Kaniatobe
• Steven Paul Kanig, M.D.
• Lindsey Kanno, DPM
• Madiha Kanwal, M.D
• Rose Ann Kao, R PH
• Kaomd JD LLC

• Physical Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.