Kenneth M Granahan, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018090 Issued in PA

Practice address

190 Welles St
Suite 166
Forty Fort, PA 18704-4968

Phone

(570) 714-4171

Fax

(570) 714-4188

NPI assigned

Jun 12, 2006

Last updated

Feb 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Intermountain Medical Group, Inc

  dba Accu Clinical Laboratory

  • Clinical Medical Laboratory
  • Kingston, PA
  • NPI 1932271624
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1710929666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WELLES ST",
            "address_2": "SUITE 166",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044968",
            "telephone_number": "570-714-4171",
            "fax_number": "570-714-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WELLES ST",
            "address_2": "SUITE 166",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044968",
            "telephone_number": "570-714-4171",
            "fax_number": "570-714-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANAHAN",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geisinger Wyoming Valley
• Charles Patrick Gelso, BS RPH
• Elizabeth Gernhardt, DO
• Roy Walter Gernhardt III, M.D., PC
• Harold Thomas Glatz, MSPT
• Robert Edward Griffin, PSYCHOLOGIST
• Jeanne Ann Grymko, L.P.C., C.A.A.D.C.
• John Michael Guarnieri, D.C.
• Louis John Guarnieri, DC
• Nancy M. Guarnieri, D.C

• Physical Therapist in Forty Fort, PA
• Providers in Forty Fort, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.