Kinetic Pediatric Therapy, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KINETIC PEDIATRIC THERAPY, INC.

Practice address

1540 E Arlington Blvd
Greenville, NC 27858-5870

Phone

(252) 902-7061

Fax

(252) 364-2863

NPI assigned

Jul 16, 2025

Organization subpart

No

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

Authorized official

Name

Charlie David Edwards, DPT

Title

Co-Owner

Phone

(252) 902-7061

Specialties & licenses 3

Addresses

Tax ID family

Kinetic Pediatric Therapy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kinetic Pediatric Therapy, Inc.

  • Behavior Analyst
  • Greenville, NC
  • NPI 1831081751
  NPD tax ID

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1124910039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-902-7061",
            "fax_number": "252-364-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-902-7061",
            "fax_number": "252-364-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC PEDIATRIC THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "252-902-7061",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Kinard, PTA
• Lori J. Kincannon, M.S., CCC-SLP
• Kind Heart Family Homecare, LLC
• Josef Henry Kinderwater, MD
• Kathleen Salmond Kinderwater, MD
• Kinetic Pediatric Therapy, Inc.
• Kinetic Phys Therapy and Wellness Inc
• Kinetic Physical Therapy and Wellness, Inc.
• Sonya Makeba King-Daniels, PHARMD
• Austin King, ATC

• Speech-Language Pathologist in Greenville, NC
• Providers in Greenville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.