Active NPI
Susan Jane Kenyon, P.T.
- Physical Therapist
- Ramona, CA
National Provider Identifier
1891093381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8574
- Practice address
- 1338 Main St
Ramona, CA 92065-2127 - Phone
- (760) 789-1400
- Fax
- (760) 789-1401
- NPI assigned
- Mar 7, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8574 | CA | Primary |
Addresses
Primary practice location
1338 Main St
Ramona, CA 92065-2127
Mailing address
PO Box 1229
Ramona, CA 92065-0865
Phone (760) 271-7575
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8574 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1891093381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1229",
"city": "RAMONA",
"state": "CA",
"postal_code": "920650865",
"telephone_number": "760-271-7575",
"fax_number": "760-788-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1338 MAIN ST",
"city": "RAMONA",
"state": "CA",
"postal_code": "920652127",
"telephone_number": "760-789-1400",
"fax_number": "760-789-1401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENYON",
"first_name": "SUSAN",
"middle_name": "JANE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-07",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "8574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ramona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.