Ngy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NGY LLC

Doing business as

Functional Health Kenosha

Practice address

1326 35TH St
Kenosha, WI 53140-5200

Phone

(630) 863-6694

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By 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

Nicole Grace Yule, PT, DPTNPI 1710335237

Title

Owner/Practitioner

Phone

(630) 863-6694

Specialties & licenses 1

Addresses

Other names 1

• Functional Health Kenosha Doing business as

Locations

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.

• Nicole Grace Yule, DPT

  • Physical Therapist
  • Burr Ridge, IL
  • NPI 1710335237
  NPD Authorized official

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1518638402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405200",
            "telephone_number": "630-863-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "YULE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "630-863-6694",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Health Kenosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.