Steven De Kenipp, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00374200 Issued in NJ

Practice address

115 Columbus Dr Ste 300
Jersey City, NJ 07302-3551

Phone

(201) 366-1118

Fax

(201) 359-3336

NPI assigned

Jul 29, 2022

Last updated

Jul 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1417683574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 COLUMBUS DR STE 300",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023551",
            "telephone_number": "201-366-1118",
            "fax_number": "201-359-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COLUMBUS DR STE 300",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023551",
            "telephone_number": "201-366-1118",
            "fax_number": "201-359-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE KENIPP",
        "first_name": "STEVEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00374200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DB Dental Professional Corporation
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• Joseph Charles De Fazio, D.C.
• Rosemary De Gennaro, MA, LPC
• Hector De Jesus
• Flavia A. De la Cruz, M.D.
• Anna Valeria De la Pena Duenas, M.D.
• Rita Guevarra De la Rosa, MD
• Tiffany De Leon-Wurm
• Nancy De Leon

• Physical Therapy Assistant in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.