Individual provider Active NPI

Kenneth R Kichura, PT

  • Physical Therapist
  • Versailles, KY
National Provider Identifier
1487953923
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008078 Issued in KY
Practice address
374 Kroger Way
Versailles, KY 40383-1915
Phone
(859) 286-6848
NPI assigned
Mar 23, 2011
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1184532 TX
Physical Therapist 225100000X 008078 KY Primary

Addresses

Primary practice location

374 Kroger Way
Versailles, KY 40383-1915

Mailing address

374 Kroger Way
Versailles, KY 40383-1915
Phone (859) 286-6848

Other practice location 1

15502 Huebner Rd
113
San Antonio, TX 78248-0998
Phone (210) 479-3334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920003934 KY Practitioner - Physical Therapist in Private Practice 2466616933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008078KYMDPhysical Therapist
1184532TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC Physical Therapist Current Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Aug 1, 2023 Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

2226 Holiday Manor Ctr
Ste 9
Louisville, KY 40222
Phone (502) 537-7870

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

12000 Aiken Rd
Louisville, KY 40243
Phone (502) 489-5002

431 Adam Shepherd Pkwy
#1
Shepherdsville, KY 40165
Phone (502) 921-0272

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1487953923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 KROGER WAY",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831915",
            "telephone_number": "859-286-6848",
            "fax_number": "859-879-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 KROGER WAY",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831915",
            "telephone_number": "859-286-6848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15502 Huebner Rd",
            "address_2": "113",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782480998",
            "country_code": "US",
            "telephone_number": "210-479-3334",
            "fax_number": "210-479-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KICHURA",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1184532",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.