Individual provider Active NPI

Kenneth Ray Carpenter, PT

  • Physical Therapist
  • Whitefish, MT
National Provider Identifier
1265870786
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5961 Issued in MT
Practice address
214 2ND St E Ste 102
Whitefish, MT 59937-2447
Phone
(406) 730-2224
Fax
(406) 730-2228
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5961 MT Primary

Addresses

Primary practice location

214 2ND St E Ste 102
Whitefish, MT 59937-2447

Mailing address

214 2ND St E Ste 102
Whitefish, MT 59937-2447
Phone (406) 730-2224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130916000703 MT Practitioner - Physical Therapist in Private Practice 8426292368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Pfister Physical Therapy PCGroup PAC ID 1759602303, 7 clinicians

Practice addresses (Care Compare)

214 2ND St E
Suite 102
Whitefish, MT 59937-2447
Phone (406) 730-2224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5961MTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pfister Physical Therapy, PC Physical Therapist CurrentSince May 27, 2023 Accepting new patients
Kalispell Regional Medical Center, Inc PastSince Jul 9, 2013 Accepting new patients

Locations

214 E 2nd St
Ste 102
Whitefish, MT 59937
Phone (406) 730-2224

Organizations & group practices 2

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1265870786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 2ND ST E STE 102",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372447",
            "telephone_number": "406-730-2224",
            "fax_number": "406-730-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 2ND ST E STE 102",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372447",
            "telephone_number": "406-730-2224",
            "fax_number": "406-730-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KENNETH",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "5961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.