Kendrele Staten, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1322180 Issued in TX

Practice address

1045 Gemini St Ste 100
Houston, TX 77058-2806

Phone

(281) 335-1111

Fax

(281) 286-9250

NPI assigned

Aug 21, 2019

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 TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marston Shaun Holt MD PAGroup PAC ID 1456534288, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Marston Shaun Holt MD PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Houston, TX
  • NPI 1841513371
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1871140236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 GEMINI ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582806",
            "telephone_number": "281-335-1111",
            "fax_number": "281-286-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GEMINI ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582806",
            "telephone_number": "281-335-1111",
            "fax_number": "281-286-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "KENDRELE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1322180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State Care Network Inc
• State Community Rehab Agency, Inc.
• State Diagnostic Clinic, LLC
• State of Texas Veterans Land Board
• State Pharmacy & Infusion Center, LLC
• Lexie Kae Staten, MS, RD
• Statera Physical Therapy and Rehabilitation Clinic, PLLC
• States Health Inc.
• Stateserv Medical of Houston, LLC
• Kimberlea Ward Staton, M.D.

• Physical Therapist in Houston, TX
• Providers in Houston, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.