Kenneth Poblete Igno

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

307445 Issued in CA

Practice address

7050 Broadway
Lemon Grove, CA 91945-1406

Phone

(619) 745-5932

NPI assigned

Jan 15, 2025

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Plus Physical Therapy, Inc.Group PAC ID 1850668773, 19 clinicians

MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• MDRS Spine & Sport, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1952394603

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Performance Plus Physical Therapy, Inc.

  • Physical Therapist
  • Chula Vista, CA
  • NPI 1144766064
  Medicare reassignment Care Compare group NPD
• MDRS Spine & Sport, Inc

  • Physical Therapist
  • Temecula, CA
  • NPI 1689824203
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1487465845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451406",
            "telephone_number": "619-745-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNO",
        "first_name": "KENNETH",
        "middle_name": "POBLETE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myisha Michelle Holloway-Griffin
• Sharayah Tanisha Horne
• Veronica Hosey
• Jihada Maria Huey
• Saida A Hussein
• Abdirizak Iman
• Imani Transportation LLC
• Kerry Ireland Song
• Kisha Irvins
• Darlene Jackson

• Physical Therapist in Lemon Grove, CA
• Providers in Lemon Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.