Kinetic Health and Performance

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KINETIC HEALTH AND PERFORMANCE

Practice address

5900 N Illinois St
Fairview Heights, IL 62208-2700

Phone

(618) 619-8200

NPI assigned

Dec 16, 2019

Last updated

May 15, 2020By 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

Mr. Kyle Brunsmann, LMT, MSRNPI 1619519725

Title

Sports Therapist / Functional Rehab

Phone

(618) 619-8200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle Brunsmann, MSR, LMT

  • Massage Therapist
  • Belleville, IL
  • NPI 1619519725
  NPD Authorized official

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1750929220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 E MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082700",
            "telephone_number": "618-619-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC HEALTH AND PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "BRUNSMANN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "SPORTS THERAPIST / FUNCTIONAL REHAB",
        "authorized_official_telephone_number": "618-619-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT, MSR"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queeda Keith
• Dawn M Kelly
• Stephanie Kelly, FNP-C
• Kaitlin Marie Kent, MA QMHP
• Desnikka Kilpatrick
• Kristen Ashley King
• Holly Renee Klein, O.D.
• Amy Luna Knox, CNS
• Dianna Koesterer
• Abigail K Konecki

• Clinic/Center in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.