Active NPI
Kylene Renee Seres
- Massage Therapist
- Minneapolis, MN
National Provider Identifier
1750597720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 4801 Minnetonka Blvd
Positive Body Dynamics
Minneapolis, MN 55416-4038 - Phone
- (952) 920-9514
- Fax
- (952) 920-9814
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
4801 Minnetonka Blvd
Positive Body Dynamics
Minneapolis, MN 55416-4038
Mailing address
3030 Lynn Ave
Apt 25
Minneapolis, MN 55416-4038
Phone (612) 306-7362
Other names 1
- Ms. Kylene Renee Coulter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750597720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 LYNN AVE",
"address_2": "APT 25",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164038",
"telephone_number": "612-306-7362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 MINNETONKA BLVD",
"address_2": "POSITIVE BODY DYNAMICS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164038",
"telephone_number": "952-920-9514",
"fax_number": "952-920-9814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERES",
"first_name": "KYLENE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KYLENE",
"last_name": "COULTER",
"middle_name": "RENEE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.