Kenneth Charleston

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT025655 Issued in PA

Practice address

708 Main St
Harleysville, PA 19438-1636

Phone

(267) 932-9177

Fax

(267) 932-9180

NPI assigned

Nov 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1275075111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 POTTSTOWN PIKE",
            "city": "CHESTER SPRINGS",
            "state": "PA",
            "postal_code": "194259518",
            "telephone_number": "610-458-6464",
            "fax_number": "610-458-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 MAIN ST",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194381636",
            "telephone_number": "267-932-9177",
            "fax_number": "267-932-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Pottstown Pike",
            "address_purpose": "LOCATION",
            "city": "Chester Springs",
            "state": "PA",
            "postal_code": "194259518",
            "country_code": "US",
            "telephone_number": "610-458-6464",
            "fax_number": "610-458-6465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLESTON",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT025655",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Harleysville, PA
• Providers in Harleysville, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.