Kinetic Kids, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5201004171 Issued in MI

Legal business name

KINETIC KIDS, LLC

Practice address

540 East Milham
Portage, MI 49002

Phone

(269) 381-1880

Fax

(269) 381-1850

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Karen Sue Galloway, OTR/LNPI 1386687861

Title

Ceo

Phone

(269) 381-1880

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Karen Sue Galloway, OTR

  • Pediatric Occupational Therapist
  • Portage, MI
  • NPI 1386687861

  Pediatrics

  NPD (past) Authorized official
• Lauren Michelle Ricker, MOT, OTR

  • Occupational Therapist
  • Fort Worth, TX
  • NPI 1154689404

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1831457142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 EAST MILHAM",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-381-1880",
            "fax_number": "269-381-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 EAST MILHAM",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-381-1880",
            "fax_number": "269-381-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC KIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "269-381-1880",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MI",
            "license": "5201004171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4719045",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kid Strides Physical Therapy LLC
• Amber Kidder
• Sheryl Lynn Kiel, MA LLP
• Stanislava Kier, LLPC
• Daniel Kik, HIS
• Jena Rae King, FNP
• Paige King
• Samantha Beth King, AU.D.
• Julie Renee Kipker, PT
• Sarah Beth Kirn-Gabrielse, D.C.

• Pediatric Occupational Therapist in Portage, MI
• Providers in Portage, MI by specialty
• Pediatric Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.