Kenneth Tillman Ethington Jr., PTA

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

5477970-2402 Issued in UT

Practice address

2707 S Adams St Apt 3
Salt Lake City, UT 84115-3350

Phone

(435) 668-2083

NPI assigned

Jul 11, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1811338445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 S ADAMS ST APT 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153350",
            "telephone_number": "435-668-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 S ADAMS ST APT 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153350",
            "telephone_number": "435-668-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHINGTON",
        "first_name": "KENNETH",
        "middle_name": "TILLMAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "UT",
            "license": "5477970-2402",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "5477970-2402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aysha-Lynn Estrella
• Madison Mae Etchegoyen
• Ethigen, LLC
• Cheryl A Ethington, LSAC
• Daniel Ethington
• Meredith Ethington
• Bruce Dennis Etringer, PH.D.
• Jaime Michelle Etterling, OD
• Mary Cornelius Etuk
• Eudemonia Space

• Geriatric Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Geriatric Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.