Kineticore Rehab Inc.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

KINETICORE REHAB INC.

Practice address

3006 Raven LN
Crestview, FL 32539-4368

Phone

(239) 401-3144

Fax

(239) 237-5366

NPI assigned

Jun 17, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Michael McNeall

Title

Board Member

Phone

(816) 964-0946

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krystal Bridgewater, PT, DPT

  • Physical Therapist
  • Naples, FL
  • NPI 1215355987
  Medicare reassignment Care Compare group NPD
• Liane Elizabeth Loots, P.T.

  • Physical Therapist
  • Boca Raton, FL
  • NPI 1609149061
  Medicare reassignment Care Compare group NPD
• Caroline Anne Walters, MA CCC SLP

  • Speech-Language Pathologist
  • Bonita Springs, FL
  • NPI 1306056627
  Medicare reassignment Care Compare group NPD
• Vanessa Chantelle Khan, MA OTR

  • Occupational Therapist
  • New York, NY
  • NPI 1841343837

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1740176387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325360127",
            "telephone_number": "239-401-3144",
            "fax_number": "239-237-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 RAVEN LN",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325394368",
            "telephone_number": "239-401-3144",
            "fax_number": "239-237-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETICORE REHAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "MCNEALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "816-964-0946",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids Dental Place
• Kids Talk Place LLC
• Kids Talk Place, LLC Dba Pediatric Therapy Center
• Jennifer Kilgore
• Connie Rhoades Killam, APRN
• Kirk Howard OD PA
• Amber L Kling
• Jung Hyun Koh, ARNP
• Joshua Kaleb Kolmetz, M.D.
• Michelle Koralewski, APRN, FNP-BC

• Occupational Therapist in Crestview, FL
• Providers in Crestview, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.