Active NPI
Kenneth Allan Juras, PT, DPT
- Physical Therapist
- Lynchburg, VA
National Provider Identifier
1306528468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305216210
- Practice address
- 3300 Rivermont Ave
Lynchburg, VA 24503-2030 - Phone
- (434) 200-4618
- Fax
- (434) 200-1294
- NPI assigned
- Aug 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | MI | ||
| Physical Therapist | 225100000X | PT40914 | FL | |
| Physical Therapist | 225100000X | 2305216210 | VA | Primary |
Addresses
Primary practice location
3300 Rivermont Ave
Lynchburg, VA 24503-2030
Mailing address
26405 Barnes St
Roseville, MI 48066-3522
Phone (586) 553-4088
Other practice location 1
26185 Greenfield Rd
Southfield, MI 48076-4709
Phone (248) 569-2040
Other names 1
- Kenneth Allan Juras
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240304000716 | VA | Practitioner - Physical Therapist in Private Practice | 3173968971 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT40914 | FL | MD | Physical Therapist |
| 2305216210 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1306528468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26405 BARNES ST",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480663522",
"telephone_number": "586-553-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 RIVERMONT AVE",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245032030",
"telephone_number": "434-200-4618",
"fax_number": "434-200-1294"
}
],
"practiceLocations": [
{
"address_1": "26185 Greenfield Rd",
"address_purpose": "LOCATION",
"city": "Southfield",
"state": "MI",
"postal_code": "480764709",
"country_code": "US",
"telephone_number": "248-569-2040",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JURAS",
"first_name": "KENNETH",
"middle_name": "ALLAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-07",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT40914",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305216210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KENNETH",
"last_name": "JURAS",
"middle_name": "ALLAN",
"credential": "PT, DPT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.