Active NPI
Kenneth Charles Rubin
- Physical Therapist
- Fort Carson, CO
National Provider Identifier
1659939262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012441
- Practice address
- 1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604 - Phone
- (719) 526-7000
- NPI assigned
- May 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12190 | CT | |
| Physical Therapist | 225100000X | 012441 | CT | Primary |
Addresses
Primary practice location
1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Mailing address
1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone (719) 526-7000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12190 | CT | MD | Clinical Social Worker |
| 012441 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729382400000",
"number": "1659939262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR UNIT MEDDAC",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "809134604",
"telephone_number": "719-526-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR UNIT MEDDAC",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "809134604",
"telephone_number": "719-526-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "KENNETH",
"middle_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-30",
"last_updated": "2024-10-20",
"certification_date": "2024-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "12190",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "012441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.