Intelkinetic Therapeutic Connections LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INTELKINETIC THERAPEUTIC CONNECTIONS LLC

Practice address

2210 Penfield LN
Bowie, MD 20716-1426

Phone

(704) 680-2834

NPI assigned

Jul 29, 2021

Organization subpart

No

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

Authorized official

Name

Jasonric Villanueva, DPT

Title

Owner/DPT

Phone

(704) 680-2834

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1215600895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 CRAIN HWY UNIT 397",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 PENFIELD LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161426",
            "telephone_number": "704-680-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELKINETIC THERAPEUTIC CONNECTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "JASONRIC",
        "authorized_official_title_or_position": "OWNER/DPT",
        "authorized_official_telephone_number": "704-680-2834",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.