Kimberly M Prucha, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT23248 Issued in FL

Practice address

837 Mount Rose St
Reno, NV 89509-3224

Phone

(850) 797-0636

NPI assigned

Mar 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Biodynamic Manual Therapy, LLC

  • Physical Therapy Clinic/Center
  • Reno, NV
  • NPI 1235503335
  NPD (past) Authorized official

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1124290523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 MOUNT ROSE ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093224",
            "telephone_number": "850-797-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 MOUNT ROSE ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093224",
            "telephone_number": "850-797-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUCHA",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BN938Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prospinal Inc
• David Leroy Prothro, MD
• Latrisha Prothro
• Natalie Proulx
• Providence Home Care
• John W Pruett, M.D.
• Hillary Pruitt, PHARMD
• Barbara Prupas, PSYD, MFT
• Erika Leigh Pruss, MD
• Prutzman & Osgood Orthopedic Surgeons (Advanced Orthopedics)

• Physical Therapist in Reno, NV
• Providers in Reno, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.