Active NPI
Kenneth James Hancock, PT
- Physical Therapist
- Nederland, TX
National Provider Identifier
1952578072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1155870
- Practice address
- 2415 Nashville Ave
Nederland, TX 77627-5714 - Phone
- (409) 504-0553
- Fax
- (409) 722-8070
- NPI assigned
- May 8, 2008
- Last updated
- May 8, 2008
- 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 | 1155870 | TX | Primary |
Addresses
Primary practice location
2415 Nashville Ave
Nederland, TX 77627-5714
Mailing address
2415 Nashville Ave
Nederland, TX 77627-5714
Phone (409) 504-0553
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 |
|---|---|---|---|
| 1155870 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1952578072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 NASHVILLE AVE",
"city": "NEDERLAND",
"state": "TX",
"postal_code": "776275714",
"telephone_number": "409-504-0553",
"fax_number": "409-722-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 NASHVILLE AVE",
"city": "NEDERLAND",
"state": "TX",
"postal_code": "776275714",
"telephone_number": "409-504-0553",
"fax_number": "409-722-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANCOCK",
"first_name": "KENNETH",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-08",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1155870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nederland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.