Kenneth James Medina, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13398641-2401 Issued in UT

Practice address

5349 Adams Ave Pkwy Ste a
Ogden, UT 84405-4736

Phone

(801) 479-9865

Fax

(801) 479-5846

NPI assigned

Jun 1, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Utah School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033822085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1831882158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 ADAMS AVE PKWY STE A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054736",
            "telephone_number": "801-479-9865",
            "fax_number": "801-479-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5349 ADAMS AVE PKWY STE A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054736",
            "telephone_number": "801-479-9865",
            "fax_number": "801-479-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "13398641-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Leslie Mechem, MSW, LCSW
• Lucero Medel Rodriguez
• Medical Hearing Clinic, Inc
• Medical Hearing Clinic, LLC
• Medical Marts,LLC
• Meeks Chropractic Inc
• Jesse L. Meeks, D.C.
• Jessica B Meents, PA-C
• Jason Meharry
• Mejken Theurer, LCSW

• Physical Therapist in Ogden, UT
• Providers in Ogden, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.