Victor D Kennel, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1060564 Issued in TX

Practice address

707 Hollybrook Dr
Suite 500
Longview, TX 75605-2410

Phone

(903) 291-6113

Fax

(903) 234-9126

NPI assigned

Nov 2, 2005

Last updated

Sep 24, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4
• Direct secure messaging: victor.kennel.1@23550.direct.athenahealth.com

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.

• Associated Clinicians of East Texas

  dba Diagnostic Clinic of Longview

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1932640349

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Regional Clinics of Longview

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1407047863
  Medicare reassignment NPD
• Associated Clinicians of East Texas

  dba Diagnostic Clinic of Longview

  • Community/Retail Pharmacy
  • Longview, TX
  • NPI 1447451406
  NPD (past)
• Diagnostic Clinic of Longview PA

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1386638468
  NPD (past)
• Lighthouse Therapy Services, Inc.

  • Physical Therapist
  • Longview, TX
  • NPI 1144276577
  NPD (past)
• Longview Specialty Physicians

  • Durable Medical Equipment & Medical Supplies
  • Longview, TX
  • NPI 1306063490
  NPD (past)
• Procedural Office Operation Professionals LLC

  • Chiropractor
  • Mount Pleasant, TX
  • NPI 1851421366

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1730170309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610393",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752610393",
            "telephone_number": "903-291-6187",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "address_2": "SUITE 500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-291-6113",
            "fax_number": "903-234-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEL",
        "first_name": "VICTOR",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1060564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171660706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Russell Kemp, M.D.
• Lauren Eliazbeth Kemp, RN
• Ken Newton Chiropractic Clinic, LLC
• Travis L. Kendall, DDS
• Sylyna G Kennedy, RN, CNM
• Fahad Jamal Khan, MD
• Malasha Khan, MD
• Rashad Mumtaz Khan, M.D.
• Sanum Khan
• Mohammad Khatib

• Physical Therapist in Longview, TX
• Providers in Longview, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.