Active NPI
Jeff G Konin, PT, PHD, ATC
- Sports Physical Therapist
- Kingston, RI
National Provider Identifier
1417050402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 02660
- Practice address
- 25 W Independence Way
University of Rhode Island
Kingston, RI 02881-1126 - Phone
- (401) 874-5627
- NPI assigned
- Sep 6, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 02660 | RI | Primary |
Addresses
Primary practice location
25 W Independence Way
University of Rhode Island
Kingston, RI 02881-1126
Mailing address
25 W Independence Way
Kingston, RI 02881-1126
Phone (401) 874-5627
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02660 | RI | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1417050402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 W INDEPENDENCE WAY",
"city": "KINGSTON",
"state": "RI",
"postal_code": "028811126",
"telephone_number": "401-874-5627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W INDEPENDENCE WAY",
"address_2": "UNIVERSITY OF RHODE ISLAND",
"city": "KINGSTON",
"state": "RI",
"postal_code": "028811126",
"telephone_number": "401-874-5627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONIN",
"first_name": "JEFF",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PT, PHD, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "RI",
"license": "02660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.