Body Structure Clinic Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

100890 Issued in KY

Legal business name

BODY STRUCTURE CLINIC INC.

Practice address

2600 Gribbin Dr
Lexington, KY 40517-4498

Phone

(859) 268-8190

Fax

(859) 268-8923

NPI assigned

May 19, 2006

Last updated

Apr 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin M. Balcirak

Title

Owner/President

Phone

(859) 268-8190

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Patrick Boland, DPT

  • Physical Therapist
  • Richmond, KY
  • NPI 1346873999

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Marie Elena Hettinger, PT, DPT, LAT, ATC

  • Physical Therapist
  • Shelbyville, KY
  • NPI 1992881817
  Medicare reassignment Care Compare group NPD
• John Virgil Borders, MD

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1962401026
  Medicare reassignment NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1174576177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 GRIBBIN DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174498",
            "telephone_number": "859-268-8190",
            "fax_number": "859-268-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GRIBBIN DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174498",
            "telephone_number": "859-268-8190",
            "fax_number": "859-268-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY STRUCTURE CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "BALCIRAK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "859-268-8190"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "100890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000061166",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James P Bodnar, MD
• Abigail Bodner
• Body Spectrum Plastic Surgery LLC
• Body Spectrum Plastic Surgery PLLC
• Body Structure Clinic
• Bodyfit Nutrition LLC (Bodyfit Nutrition)
• Andrew Boeckley, MD
• Polly Blake Buckey Boehnlein, DDS
• Andrea Boelhauf, LMT
• Marissa Marcinek Boelhauf, PHARM.D.

• Physical Therapist in Lexington, KY
• Providers in Lexington, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.