Ken Winston Cloma Itoh

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1368766 Issued in TX

Practice address

5425 W Spring Creek Pkwy Ste 270
Plano, TX 75024-4317

Phone

(972) 656-0431

Fax

(972) 801-2191

NPI assigned

Feb 17, 2023

Sex

Male

Sole proprietor

Yes

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 TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Synergy Care Southeast, LLC

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  TX

  Medicare reassignment

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1760180913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 HAVERWOOD LN APT 911D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752874422",
            "telephone_number": "575-631-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY STE 270",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244317",
            "telephone_number": "972-656-0431",
            "fax_number": "972-801-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITOH",
        "first_name": "KEN WINSTON",
        "middle_name": "CLOMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT6177",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1368766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humaira Islam, MD
• Brady Scott Ismond
• Omar Issa
• It3 Medical LLC
• Saadie Itani, MS., RD., LD
• Selena Iturbe
• Debra K Iversen, LCSW
• Michelle Ivy, MS, RDN, CDCES
• Iyengar Assist, PLLC
• Iyengar Monitoring, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.