Kspmd LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.060428 Issued in OH

Legal business name

KSPMD LLC

Doing business as

The Center For Lifestyle Change

Practice address

45 McClurg Rd
Boardman, OH 44512-6737

Phone

(888) 565-6754

Fax

(330) 746-1315

NPI assigned

Feb 22, 2013

Organization subpart

No

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

Authorized official

Name

Kathleen S Padgitt, MD

Title

President

Phone

(888) 565-6754

Specialties & licenses 1

Addresses

Other names 1

• The Center For Lifestyle Change Doing business as

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1730429192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MCCLURG RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126737",
            "telephone_number": "888-565-6754",
            "fax_number": "330-746-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MCCLURG RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126737",
            "telephone_number": "888-565-6754",
            "fax_number": "330-746-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSPMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "PADGITT",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-565-6754",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.060428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center For Lifestyle Change",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Marie Koleszar, LPC
• Robert Koller, DO
• Aran Kongmuang, M.D.
• Jennifer Lynn Krasnicki, PHARMD
• Kierra Kruisselbrink
• Bradley Robert Kubis, OD
• Sarah J Kudelko, PA-C
• Emily Kunselman, OT
• Jacquelyn Marie Kutchel
• Helena Valentina Ladd, PHARMD, RPH, BCPS

• Internal Medicine Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.