Kimberlee Michele Raynovich, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2253PT Issued in MT

Practice address

612 E. Main St,
Ste C Epicenter Therapy Services
Bozeman, MT 59715

Phone

(406) 522-3722

NPI assigned

Apr 20, 2007

Last updated

Aug 31, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epicenter Therapy Services PLLC

  • Occupational Therapy Assistant
  • Bozeman, MT
  • NPI 1164551222

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1558588368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 TRIPLE TREE RD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597157852",
            "telephone_number": "406-587-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E. MAIN ST,",
            "address_2": "STE C EPICENTER THERAPY SERVICES",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-522-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOVICH",
        "first_name": "KIMBERLEE",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "2253PT",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "40QA00357200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lloyd Rase, M.D.
• Rebecca Lynn Rassi, FNP-BC
• Rachel Ratchford, PA-C
• Jamie Rawson, PCA, NREMT
• Kathleen Ray, PHARMD
• Reach, Inc.
• Reaching Ahead PLLC
• Rector Orthodontics
• Lisa Paige Reddan, MS RD CDE
• Nicole Joanna Reddinger, CPT

• Physical Therapist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.