Active NPI
Kenny Shih
- Physical Therapy Assistant
- Germantown, MD
National Provider Identifier
1801479977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A4505
- Practice address
- 19851 Observation Dr Ste 450
Germantown, MD 20876-4148 - Phone
- (301) 977-3605
- NPI assigned
- May 5, 2021
- Last updated
- May 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | A4505 | MD | Primary |
Addresses
Primary practice location
19851 Observation Dr Ste 450
Germantown, MD 20876-4148
Mailing address
2722 Deer Ridge Dr
Silver Spring, MD 20904-7100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sanford.html |
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 |
|---|---|---|---|
| A4505 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1801479977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2722 DEER RIDGE DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209047100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19851 OBSERVATION DR STE 450",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764148",
"telephone_number": "301-977-3605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIH",
"first_name": "KENNY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A4505",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sanford.html",
"affiliation": "N",
"address_1": "19851 Observation Dr Ste 450",
"city": "Germantown",
"state": "MD",
"country_code": "US",
"postal_code": "208764148",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.