Kinetic Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070002318 Issued in IL

Legal business name

KINETIC REHAB LLC

Practice address

410 N 2ND St
Marshall, IL 62441-1010

Phone

(217) 826-2365

Fax

(217) 826-8120

NPI assigned

Nov 9, 2009

Last updated

Mar 5, 2010By 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

Mrs. Nancy M Rhoads

Title

Office Manager

Phone

(217) 826-2365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cork Physical Therapy Other name

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1942537188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "address_2": "410 N SECOND STREET",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624410040",
            "telephone_number": "217-826-2365",
            "fax_number": "217-826-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 2ND ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411010",
            "telephone_number": "217-826-2365",
            "fax_number": "217-826-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "RHOADS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-826-2365",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070002318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS KINETIC",
            "identifier": "1232012",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cork Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peggy Ann Hutson
• Kathy L Jackson
• Amy C James, MD
• Taylor Erin Janes, FNP-BC
• Jeffrey Bruce Wellum (Wellum Chiropractic)
• King Chiropractic Clinic, LTD. (King Chiropractic Clinic)
• William Lee King, DC
• Glenna V. Kreckman Hiett, L.M.F.T.
• Steven Macke, MD
• Marshall Comm Unit School Dist 2

• Physical Therapist in Marshall, IL
• Providers in Marshall, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.