Kidnetic Energy,Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT007370 Issued in GA

Legal business name

KIDNETIC ENERGY,INC

Practice address

536 Grand Slam Dr
Evans, GA 30809-8014

Phone

(706) 854-8434

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Tiffany Christine Maguire

Title

Office Manager

Phone

(706) 854-8434

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578600391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098014",
            "telephone_number": "706-854-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098014",
            "telephone_number": "706-854-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNETIC ENERGY,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGUIRE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-854-8434"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Kennerly
• Shauna Lynne Kenney, LPC
• Jeff Thomas Kertscher, PT
• Kristy Kertscher, P.T.
• Celina Keys, LCSW
• Rhoda Kimble-Wheeler, CADC II, CCJP, US DO
• James Fitzhugh Kimbrough, MD
• Kingdom Travel Transportation LLC
• Jalen Kingston-Moore
• Abigail Schwartz Kinkella, PA-C

• Physical Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Physical Therapist in Georgia

• 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.