NPIMap

Organization Active NPI

Kime Performance Nevada LLC

  • Physical Therapy Clinic/Center
  • Reno, NV
National Provider Identifier
1053918185
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KIME PERFORMANCE NEVADA LLC
Practice address
5301 Longley LN Ste 81
Reno, NV 89511-1868
Phone
(916) 905-6378
NPI assigned
Oct 1, 2020
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Anthony R Mikla, PTNPI 1578647996
Title
Ceo
Phone
(916) 342-4190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5301 Longley LN Ste 81
Reno, NV 89511-1868

Mailing address

5301 Longley LN Ste 81
Reno, NV 89511-1868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201107000148 NV Part B Supplier - Clinic/Group Practice 0042620783 Receives reassigned benefits from 10 practitioners
Practice locations: Las Vegas, NV; Reno, NV

National Provider Directory

National Provider Directory

Locations

4990 Hillsdale Cir
Ste 100
El Dorado Hls, CA 95762
Phone (916) 342-4190

9340 W Flamingo Rd
Ste 118
Las Vegas, NV 89147

3000 Airway Dr
Ste 175
Reno, NV 89502

5301 Longley Ln
Ste 81
Reno, NV 89511

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1053918185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 LONGLEY LN STE 81",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 LONGLEY LN STE 81",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111868",
            "telephone_number": "916-905-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIME PERFORMANCE NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "MIKLA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-342-4190",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.