NPIMap

Organization Active NPI

Kineta Rehab Solutions, LLC

  • Contractor
  • Alexandria, VA
National Provider Identifier
1457607889
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
0119003001 Issued in VA
Legal business name
KINETA REHAB SOLUTIONS, LLC
Practice address
53 S Gordon St
Alexandria, VA 22304-4929
Phone
(703) 587-1907
Fax
(571) 970-6125
NPI assigned
Aug 3, 2012
Last updated
Aug 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Authorized official

Name
Mrs. Joyce C Jefferson, LPTANPI 1659807402
Title
Owner
Phone
(703) 587-1907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 2306601555 VA
Contractor 171W00000X 0119003001 VA Primary

Addresses

Primary practice location

53 S Gordon St
Alexandria, VA 22304-4929

Mailing address

53 S Gordon St
Alexandria, VA 22304-4929
Phone (703) 587-1907

National Provider Directory

National Provider Directory
Tax ID family
Kineta Rehab Solutions LLC2 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1457607889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 S GORDON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044929",
            "telephone_number": "703-587-1907",
            "fax_number": "571-970-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 S GORDON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044929",
            "telephone_number": "703-587-1907",
            "fax_number": "571-970-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETA REHAB SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-587-1907",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "2306601555",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "0119003001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.