Active NPI
Charles Kettenring, DPT
- Physical Therapist
- Albuquerque, NM
National Provider Identifier
1841960184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5130 San Francisco Rd NE Ste B
Albuquerque, NM 87109-4618 - Phone
- (505) 823-2411
- NPI assigned
- Sep 17, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
5130 San Francisco Rd NE Ste B
Albuquerque, NM 87109-4618
Mailing address
6564 Los Pueblos PL NW
Albuquerque, NM 87114-4451
Phone (801) 671-4600
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1841960184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6564 LOS PUEBLOS PL NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871144451",
"telephone_number": "801-671-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5130 SAN FRANCISCO RD NE STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094618",
"telephone_number": "505-823-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTENRING",
"first_name": "CHARLES",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-17",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.