Dynamic Kids Therapy Az LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DYNAMIC KIDS THERAPY AZ LLC

Practice address

3026 W Ferruccio PL
Phoenix, AZ 85086-3217

Phone

(614) 270-4607

NPI assigned

Dec 19, 2019

Organization subpart

No

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

Authorized official

Name

Matthew James ClipnerNPI 1942560693

Title

Ceo

Phone

(614) 270-4607

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew James Clipner

  • Contractor
  • Phoenix, AZ
  • NPI 1942560693
  NPD Authorized official

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1467090597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 W FERRUCCIO PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850863217",
            "telephone_number": "614-270-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3026 W FERRUCCIO PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850863217",
            "telephone_number": "614-270-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC KIDS THERAPY AZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "CLIPNER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-270-4607"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699173",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Jane Dykstra, FNP-C
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• Dynamic Dental Health Associates of Arizona
• Dynamic Foot and Ankle, PLLC
• Dynamic Living Counseling Inc
• Dynamic Medical Systems, Inc.
• Dynamic Medical Transport
• Dynamic Pain Management PLLC
• Dynamix Imaging Solutions LLC

• Home Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.