Active NPI
Kenneth Shane White, PT, WCC
- Physical Therapist
- Atmore, AL
National Provider Identifier
1750404331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH3582
- Practice address
- 401 Medical Park Dr
Atmore, AL 36502-3006 - Phone
- (251) 368-6346
- Fax
- (251) 368-6255
- NPI assigned
- Apr 9, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH3582 | AL | Primary |
Addresses
Primary practice location
401 Medical Park Dr
Atmore, AL 36502-3006
Mailing address
817 Meadows Dr
Atmore, AL 36502-3306
Phone (251) 368-2726
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH3582 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750404331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 MEADOWS DR",
"city": "ATMORE",
"state": "AL",
"postal_code": "365023306",
"telephone_number": "251-368-2726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 MEDICAL PARK DR",
"city": "ATMORE",
"state": "AL",
"postal_code": "365023006",
"telephone_number": "251-368-6346",
"fax_number": "251-368-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "KENNETH",
"middle_name": "SHANE",
"credential": "PT, WCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH3582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atmore, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.