Kinected Physical Therapy & Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KINECTED PHYSICAL THERAPY & WELLNESS

Practice address

635 Bert Kouns Industrial Loop Ste 400
Shreveport, LA 71118-5704

Phone

(318) 408-1600

NPI assigned

Oct 25, 2022

Last updated

Oct 25, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Latisha Williams, PT, DPTNPI 1780153023

Title

Owner

Phone

(318) 408-1600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latisha Levelma Williams, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1780153023
  Medicare reassignment NPD Authorized official
• Denise Rae Gerrity, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1346826393
  Medicare reassignment NPD

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1053038414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "STE 203 #123",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BERT KOUNS INDUSTRIAL LOOP STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711185704",
            "telephone_number": "318-408-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINECTED PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-408-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coretta Smith Kimble, M.A.
• Darrick Kinchen
• Destiny Kindells
• Frederick John Kinder Jr., MD
• Kindled Keys of Counseling, LLC
• Zaldjuanaka King-Douglas
• Raven Janeen King-Smith
• Alice Mae King, SWS
• April King
• Ashley King, BCBA

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.