Kinetic Physical Therapy and Spine PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

KINETIC PHYSICAL THERAPY AND SPINE PC

Practice address

199 Main St
Keansburg, NJ 07734-1734

Phone

(732) 495-0905

NPI assigned

Mar 12, 2014

Last updated

Mar 12, 2014By 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

Dr. Stephen Costa, DC

Title

President

Phone

(732) 495-0905

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1720404940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341734",
            "telephone_number": "732-495-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341734",
            "telephone_number": "732-495-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC PHYSICAL THERAPY AND SPINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-495-0905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Keansburg, NJ
• Providers in Keansburg, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.