Organization Active NPI

Kinetic Health Solutions LLC

  • Physical Therapist
  • Ridgewood, NJ
National Provider Identifier
1083235576
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KINETIC HEALTH SOLUTIONS LLC
Practice address
153 Prospect St
Ridgewood, NJ 07450-4405
Phone
(201) 746-5860
NPI assigned
May 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Dr. Shivaz Rose, DPT
Title
Owner
Phone
(201) 746-5860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

153 Prospect St
Ridgewood, NJ 07450-4405

Mailing address

153 Prospect St
Ridgewood, NJ 07450-4405
Phone (201) 746-5860

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1083235576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-746-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-746-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC HEALTH SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "SHIVAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-746-5860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.