Kimberly Mary Hallack, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01400200 Issued in NJ

Practice address

350 Main Rd
Suite 200
Montville, NJ 07045-9222

Phone

(973) 263-9855

NPI assigned

Sep 14, 2011

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

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sportscare of America, PC

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1851484380
  Medicare reassignment NPD
• Elc Rehabilitation

  • Physical Therapy Clinic/Center
  • Kinnelon, NJ
  • NPI 1497264337
  Medicare reassignment
• Sportscare Institute, Inc.

  • Physical Therapist
  • Toms River, NJ
  • NPI 1275501074
  NPD (past)

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1144502220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "address_2": "SUITE 201",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN RD",
            "address_2": "SUITE 200",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459222",
            "telephone_number": "973-263-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLACK",
        "first_name": "KIMBERLY",
        "middle_name": "MARY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01400200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina G Grinshpun, DPT
• Toni Durino Groelly, L.AC
• Elizabeth Guida, RPH
• Shibani Gupta, OTR
• Stacy Rebecca Gurbarg, DDS
• Lindsay Hammond-Schumacher, RD
• Kaitlin Harper
• Jay J Hartman, MSW, LCSW
• Lisa Heller, M.S., CCC-SLP
• Sharna Hemrajani, DMD

• Physical Therapist in Montville, NJ
• Providers in Montville, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.