Kenneth Joseph King, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3935 Issued in TX

Practice address

23203 Bulverde Rd
San Antonio, TX 78259-2203

Phone

(210) 356-0400

NPI assigned

Mar 2, 2021

Last updated

Mar 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kenny Joseph King Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1528653557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8976 SCARLET CRK",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781483785",
            "telephone_number": "210-445-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23203 BULVERDE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592203",
            "telephone_number": "210-356-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "3935",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNY",
            "last_name": "KING",
            "middle_name": "JOSEPH",
            "credential": "LAT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jaliece King
• Jessica Marie King
• John Chandler King, M.D.
• Joseph King
• Keith King
• Kevin Michael King, M.D.
• Lauren Nicole King, OTR
• Lindsay D King
• Mary Sue King, P.T.
• Maureen Sullivan King, PH.D.

• Athletic Trainer in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.