Active NPI
Chikumbutso Ellen Kankhwende, PTA
- Geriatric Physical Therapist
- Olney, MD
National Provider Identifier
1821286030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- A3131
- Practice address
- 3504 Softwood Ter
Olney, MD 20832-2200 - Phone
- (240) 342-2312
- NPI assigned
- Oct 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | A3131 | MD | Primary |
Addresses
Primary practice location
3504 Softwood Ter
Olney, MD 20832-2200
Mailing address
3504 Softwood Ter
Olney, MD 20832-2200
Phone (240) 342-2312
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 |
|---|---|---|---|
| A3131 | MD | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1821286030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3504 SOFTWOOD TER",
"city": "OLNEY",
"state": "MD",
"postal_code": "208322200",
"telephone_number": "240-342-2312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3504 SOFTWOOD TER",
"city": "OLNEY",
"state": "MD",
"postal_code": "208322200",
"telephone_number": "240-342-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANKHWENDE",
"first_name": "CHIKUMBUTSO",
"middle_name": "ELLEN",
"name_prefix": "Miss",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-12",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "MD",
"license": "A3131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.