Kinetic Physical Therapy PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

KINETIC PHYSICAL THERAPY PLLC

Practice address

5089 W Herriman Blvd Ste 2B
Herriman, UT 84096-2599

Phone

(480) 206-1591

NPI assigned

Jul 26, 2021

Organization subpart

No

Name

Mr. Sean Aaron Miller, PTNPI 1023037389

Title

Ceo/Owner

Phone

(480) 206-1591

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

• Sean A Miller, MPT

  • Physical Therapist
  • Herriman, UT
  • NPI 1023037389
  Medicare reassignment Care Compare group NPD Authorized official
• Dane Scott Albrecht, PT, DPT

  • Physical Therapist
  • Orem, UT
  • NPI 1366060139
  Medicare reassignment Care Compare group NPD
• Reed Carter

  • Physical Therapist
  • Provo, UT
  • NPI 1689104812
  Medicare reassignment Care Compare group NPD
• Robert William Lund, DPT

  • Physical Therapist
  • Herriman, UT
  • NPI 1598122657
  Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 7, 2021.

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1831862903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17939 E APPALOOSA DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424529",
            "telephone_number": "480-206-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5089 W HERRIMAN BLVD STE 2B",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840962599",
            "telephone_number": "480-206-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "480-206-1591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jsa Nutrition
• McKinnah Darva Judd, RBT
• Java Kalati
• Justen M Kho, DPT
• Rachel Kimball
• Jake Kocherhans, FDNP
• Kyung-Ran Koh, CMHC
• Simon Kuczinna
• Tara La Bella
• Blakelee Danyelle Lafrancois

• All providers in Herriman, UT
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.