Individual provider Active NPI

Kenneth Huebner, PT

  • Physical Therapy Clinic/Center
  • Boynton Beach, FL
National Provider Identifier
1295902369
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT 23455 Issued in FL
Practice address
1101 N Congress Ave
Suite 208
Boynton Beach, FL 33426-3336
Phone
(561) 736-0294
Fax
(561) 369-3544
NPI assigned
May 8, 2008
Last updated
May 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT 23455 FL Primary

Addresses

Primary practice location

1101 N Congress Ave
Suite 208
Boynton Beach, FL 33426-3336

Mailing address

8411 Dynasty Dr
Boca Raton, FL 33433-6841
Phone (561) 213-5855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 23455FLMDPhysical Therapy Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1295902369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 DYNASTY DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334336841",
            "telephone_number": "561-213-5855",
            "fax_number": "561-369-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CONGRESS AVE",
            "address_2": "SUITE 208",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263336",
            "telephone_number": "561-736-0294",
            "fax_number": "561-369-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBNER",
        "first_name": "KENNETH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT 23455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.