Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MR. KENNETH P STACK
Active
Individual
MR. KENNETH P STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,MS,CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8899
NC
2251G0304X
Geriatric Physical Therapist
8899
NC
2251S0007X
Sports Physical Therapist
8899
NC
2251X0800X
Orthopedic Physical Therapist
8899
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078V4
BCBS
NC
01
—
11337022
CAQH
—
05
—
7212592
—
NC
Enumeration date
10/27/2005
Last updated
03/27/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up