Individual provider Active NPI

Kenny Sargent, DPT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1336289685
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7585 Issued in AZ
Practice address
1616 N Litchfield Rd
Suite 115
Goodyear, AZ 85395-1252
Phone
(623) 935-0734
Fax
(623) 935-0934
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 7585 AZ Primary

Addresses

Primary practice location

1616 N Litchfield Rd
Suite 115
Goodyear, AZ 85395-1252

Mailing address

9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6279
Phone (480) 860-4298

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070529000253 AZ Practitioner - Physical Therapist in Private Practice 1759488653 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7585AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Aug 18, 2008 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
Spooner Rehab, PC Physical Therapist CurrentSince Aug 18, 2008 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Mar 1, 2018 Accepting new patients

Locations

10721 W Indian School Rd
Avondale, AZ 85392
Phone (623) 772-7748

5281 N 99th Ave
Ste 200
Glendale, AZ 85305
Phone (623) 889-0411

1626 N Litchfield Rd
Ste 310
Goodyear, AZ 85395
Phone (623) 680-0036

1616 N Litchfield Rd
Ste 115
Goodyear, AZ 85395
Phone (623) 935-0734

8643 W Kelton Ln
Ste 106
Peoria, AZ 85382
Phone (623) 979-8900

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

Organizations & group practices 5

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1336289685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606279",
            "telephone_number": "480-860-4298",
            "fax_number": "480-860-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N LITCHFIELD RD",
            "address_2": "SUITE 115",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951252",
            "telephone_number": "623-935-0734",
            "fax_number": "623-935-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "KENNY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.

Verify at the official NPI Registry.