NPIMap

Organization Active NPI

Kinetic Conditioning Institute, Inc

  • Physical Therapist
  • Montrose, CA
National Provider Identifier
1952474066
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20048 Issued in CA
Legal business name
KINETIC CONDITIONING INSTITUTE, INC
Practice address
4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520
Phone
(818) 957-1980
Fax
(818) 957-1905
NPI assigned
Nov 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Leizl-Ann M Adolphi, PTNPI 1083761209
Title
Owner
Phone
(818) 957-1980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT20048 CA Primary

Addresses

Primary practice location

4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520

Mailing address

4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520
Phone (818) 957-1980

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952474066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 OCEAN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201520",
            "telephone_number": "818-957-1980",
            "fax_number": "818-957-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 OCEAN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201520",
            "telephone_number": "818-957-1980",
            "fax_number": "818-957-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC CONDITIONING INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADOLPHI",
        "authorized_official_first_name": "LEIZL-ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-957-1980",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.