Individual provider Active NPI

Kanisha Shenell Aikin, MPT

  • Physical Therapist
  • Katy, TX
National Provider Identifier
1528209509
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1169492 Issued in TX
Practice address
21720 Kingsland Blvd
Katy, TX 77450-2550
Phone
(800) 447-3422
NPI assigned
Mar 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1169492 TX Primary

Addresses

Primary practice location

21720 Kingsland Blvd
Katy, TX 77450-2550

Mailing address

24715 Mason Knights CT
Katy, TX 77493-2762
Phone (832) 689-8534

Other practice location 1

17705 Red Oak Dr
Houston, TX 77090-7706
Phone (281) 397-7711

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

LicenseStateTypeSpecialty
1169492TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JLB Rehabilitation & Wellness LLC Physical Therapist CurrentSince Nov 15, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1528209509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 MASON KNIGHTS CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932762",
            "telephone_number": "832-689-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21720 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502550",
            "telephone_number": "800-447-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17705 Red Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770907706",
            "country_code": "US",
            "telephone_number": "281-397-7711",
            "fax_number": "281-397-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AIKIN",
        "first_name": "KANISHA",
        "middle_name": "SHENELL",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-20",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1169492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.