Convergent Movement and Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01566100 Issued in NJ

Legal business name

CONVERGENT MOVEMENT AND PERFORMANCE LLC

Practice address

1200 US Highway 22 East
Suite 2000 Unit W7
Bridgewater, NJ 08807-2943

Phone

(908) 304-3620

NPI assigned

Apr 1, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Eugene Ketselman, D.P.T.NPI 1639579279

Title

Owner Physical Therapist

Phone

(908) 304-3620

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Eugene Ketselman, PT, DPT, FAAOMPT

  • Physical Therapist
  • Bridgewater, NJ
  • NPI 1639579279
  NPD (past) Authorized official

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1104358787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 ROUTE 202",
            "address_2": "SUITE 320 UNIT 200",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 US HIGHWAY 22 EAST",
            "address_2": "SUITE 2000 UNIT W7",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072943",
            "telephone_number": "908-304-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Stirling Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "NJ",
            "postal_code": "070595238",
            "country_code": "US",
            "telephone_number": "908-304-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONVERGENT MOVEMENT AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-01",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "KETSELMAN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "908-304-3620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01566100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Complete Family Eye Care Optometry PA
• Elisabeth Comune
• Kaitlyn Conaboy
• Rebecca Lynn Conover, PT
• Consistent Supports Coordination, LLC
• Elizabeth F Cook, M.D.
• Robin Cook
• Lisa Coppola, MA
• Tanya Copprue-Lanham, MSW, HS-BCP, CSS
• Samantha Ann Cordero, LMFT

• Physical Therapy Clinic/Center in Bridgewater, NJ
• Providers in Bridgewater, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.