Kinetic Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

826 Issued in AK

Legal business name

KINETIC PHYSICAL THERAPY LLC

Practice address

5193 Borch St
Ketchikan, AK 99901-9036

Phone

(907) 617-4402

Fax

(907) 247-7868

NPI assigned

Sep 23, 2010

Organization subpart

No

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

Authorized official

Name

Leah Marie PagenkopfNPI 1215136924

Title

Physical Therapist

Phone

(907) 617-4402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 1

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

• Leah Pagenkopf, MPT

  • Physical Therapist
  • Juneau, AK
  • NPI 1215136924
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1508174541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 794",
            "city": "WARD COVE",
            "state": "AK",
            "postal_code": "999280794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5193 BORCH ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999019036",
            "telephone_number": "907-617-4402",
            "fax_number": "907-247-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "PAGENKOPF",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "907-617-4402"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AK",
            "license": "826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Kimball
• Sheila Lynne Kimble-Haas, C.N.M., CFNP
• Dru Kindred, DC, LAC
• Debra Kinerk, CDC I
• Michael Kinerk
• Dominique King
• Sandra Rose King
• Olivia Renee Kinunen, RN
• Scott Myers Kirchner, MD
• Louis E. Kleager, M.D.

• Physical Therapy Clinic/Center in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Physical Therapy Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.