Active NPI
Kenneth Alexis Correa I
- Clinical Social Worker
- Manati, PR
National Provider Identifier
1477251288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16354
- Practice address
- CDT Cesar Rosa Febles Edificio Anejo Piso2 Sr 2, KM 50,
Manati, PR 00617 - Phone
- (787) 641-9133
- NPI assigned
- Feb 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16354 | PR | Primary |
Addresses
Primary practice location
CDT Cesar Rosa Febles Edificio Anejo Piso2 Sr 2, KM 50,
Manati, PR 00617
Mailing address
PO Box 1570
Barceloneta, PR 00617-1570
Phone (787) 970-4634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16354 | Other | PR | APS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16354 | PR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1477251288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1570",
"city": "BARCELONETA",
"state": "PR",
"postal_code": "006171570",
"telephone_number": "787-970-4634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CDT CESAR ROSA FEBLES EDIFICIO ANEJO PISO2 SR 2, KM 50,",
"city": "MANATI",
"state": "PR",
"postal_code": "00617",
"telephone_number": "787-641-9133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA",
"first_name": "KENNETH",
"middle_name": "ALEXIS",
"name_prefix": "Mr.",
"name_suffix": "I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-21",
"last_updated": "2023-02-21",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "16354",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS",
"identifier": "16354",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
- Corporacion Las Vegas Inc (Clinica Terapia Fisica Y Rehabilitacion del Norte)
- Corporacion Las Vegas, LLC
- Corporacion Profesional de Servicios de Salud (Grupo Medico de Manati)
- Carlos Alberto Correa Roman, MD
- Javier E Correa Roman
- Alfredo J Corretjer, MD
- Juan Carlos Cortes Melendez
- Deborah Cosme Torres, PH
- Tayra I Cotto Febles, MD
- Susanne Marie Crespo Ramos, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.