Kenneth Ngwu Jr., PT, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11553 Issued in SC

Practice address

13937 S Sprague LN Ste 100
Draper, UT 84020-7864

Phone

(385) 308-8034

NPI assigned

Nov 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Collective Therapy Corp.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1396380911

  Physical Therapist, SC

  Medicare reassignment NPD
• Prava PC

  • Physical Therapist
  • Chicago, IL
  • NPI 1841003753

  NC, SC

  Medicare reassignment NPD
• Reinvent Health Inc

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1215763206

  NC, Physical Therapist, SC

  Medicare reassignment NPD

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1730585092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13937 S SPRAGUE LN STE 100",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207864",
            "telephone_number": "385-308-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13937 S SPRAGUE LN STE 100",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207864",
            "telephone_number": "385-308-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGWU",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-14",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15291",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elijah Newall
• Breanna Newbold
• Keira Newton
• Katielyn Ngambi
• Charlie Ngo
• Jeannise Marie Nichols, OT
• Jen Nichols
• Madison Nichols
• Jill Carolyn Nicholson, ARNP
• Emily Nielsen

• Physical Therapist in Draper, UT
• Providers in Draper, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.