Kinetic Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016454 Issued in PA

Legal business name

KINETIC REHAB LLC

Practice address

2373 Delo Dr
Gibsonia, PA 15044-9158

Phone

(724) 713-1964

Fax

(412) 202-9770

NPI assigned

Apr 18, 2007

Last updated

Aug 22, 2020By 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

Kathryn S Wallace, DPTNPI 1639254246

Title

President

Phone

(724) 713-1964

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, and the practitioner matching its NPPES authorized official.

• Kathryn Susan Wallace, D.P.T.

  • Physical Therapist
  • Oshkosh, WI
  • NPI 1639254246
  Authorized official Same address or phone

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538386172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 DELO DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449158",
            "telephone_number": "724-713-1964",
            "fax_number": "412-202-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 DELO DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449158",
            "telephone_number": "724-713-1964",
            "fax_number": "412-202-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-713-1964",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101794666 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Rae Kennelly
• Lauren Elizabeth Kenney, OTR/L
• Jennifer West Ketler, LPC
• Kimmey Enterprises (Richland Chiropractic Center)
• Douglas G Kimmey, D.C.
• Tonya Klein-Jackson
• Kaitlyn Kline
• Andrew Koffmann, PH.D.
• Samantha Kollar, PT, DPT
• Holly Komoroski

• Physical Therapist in Gibsonia, PA
• Providers in Gibsonia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.