Organization Active NPI

KNH LLC

  • Physical Therapist
  • Conway, AR
National Provider Identifier
1659640605
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KNH LLC
Practice address
235 Castleberry Dr
Conway, AR 72034-7798
Phone
(501) 733-0104
NPI assigned
Dec 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Kenneth Holder, DPTNPI 1740514058
Title
Owner
Phone
(501) 733-0104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

235 Castleberry Dr
Conway, AR 72034-7798

Mailing address

PO Box 11226
Conway, AR 72034-0022
Phone (501) 733-0104

Other names 1

  • Elite Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120220000841 AR Part B Supplier - Clinic/Group Practice 0244498475 Receives reassigned benefits from 7 practitioners
Practice locations: Conway, AR; Perryville, AR

National Provider Directory

National Provider Directory

Locations

635 Dave Ward Dr
Ste 104
Conway, AR 72034
Phone (501) 205-4695

130 Houston Ave
Ste C
Perryville, AR 72126
Phone (501) 889-1900

236 Houston Ave
Perryville, AR 72126
Phone (501) 889-1900

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1659640605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11226",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720340022",
            "telephone_number": "501-733-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CASTLEBERRY DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347798",
            "telephone_number": "501-733-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-733-0104",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.