Individual provider Active NPI

Kenneth J McConnehey, DPT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1790015154
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 00010255 Issued in WA
Practice address
210 S 72ND Ave Ste 130
Yakima, WA 98908-1689
Phone
(509) 453-3103
NPI assigned
Jan 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 00010255 WA Primary

Addresses

Primary practice location

210 S 72ND Ave Ste 130
Yakima, WA 98908-1689

Mailing address

16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835

Other identifiers 2

IdentifierTypeStateIssuer
P01270248OtherWARR MEDICARE
1790015154MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100309000174 WA Practitioner - Physical Therapist in Private Practice 0749325223 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RPM Rehab IncGroup PAC ID 0244313187, 19 clinicians
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

1608 S 24TH Ave
Suite 102
Yakima, WA 98902-5719
Phone (509) 248-6113

17700 SE Mill Plain Blvd
Suite 150
Vancouver, WA 98683-7582
Phone (360) 514-9383

210 S 72ND Ave
Suite 130
Yakima, WA 98908-1689
Phone (509) 453-3103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 00010255WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premere Rehab LLC Physical Therapist CurrentSince Jul 15, 2015 Accepting new patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
RPM Rehab, Inc Physical Therapist CurrentSince Mar 15, 2026 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Apr 6, 2015 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Apr 6, 2015 Accepting new patients
Premere Rehab, LLC Physical Therapist CurrentSince Jul 15, 2015 Accepting new patients
Peak Performance Sports and Spine Physical Therapist PastSince Nov 1, 2005 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (503) 570-3365

4250 Martin Way E
Ste 105
Olympia, WA 98516
Phone (360) 486-0640

304 S 1st St
Ste A
Selah, WA 98942
Phone (509) 697-5330

17700 SE Mill Plain Blvd
Ste 150
Vancouver, WA 98683
Phone (360) 514-9383

2505 Racquet Ln
Yakima, WA 98902
Phone (509) 453-7325

1608 S 24th Ave
Ste 102
Yakima, WA 98902
Phone (509) 248-6113

210 S 72nd Ave
Ste 130
Yakima, WA 98908
Phone (509) 453-3103

3801 Summitview Ave
Yakima, WA 98902
Phone (509) 853-1805

Interoperability endpoints

  • Direct secure messaging: kenneth.mcconnehey.1@31414.direct.athenahealth.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1790015154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "SUITE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "800-219-8835",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 72ND AVE STE 130",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081689",
            "telephone_number": "509-453-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNEHEY",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 00010255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01270248",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790015154",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.