Active NPI
Kinetic O & P, LTD
- Prosthetic/Orthotic Supplier
- Bourbonnais, IL
National Provider Identifier
1972908663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 213000210
- Legal business name
- KINETIC O & P, LTD
- Practice address
- 453 S Main
Bourbonnais, IL 60914-1918 - Phone
- (815) 401-7260
- Fax
- (815) 401-7267
- NPI assigned
- Oct 24, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Aaron Hays
- Title
- President/Cpo
- Phone
- (815) 401-7260
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 213000210 | IL | Primary |
Addresses
Primary practice location
453 S Main
Bourbonnais, IL 60914-1918
Mailing address
453 S Main
Bourbonnais, IL 60914-1918
Phone (815) 401-7260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150407000668 | IL | DME Supplier - Certified Orth/Pros/Pedorthist | 7810215605 | Practice locations: Bourbonnais, IL |
National Provider Directory
National Provider Directory- Tax ID family
- Kinetic O P LTD
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Valparaiso, IN
- NPI 1205336542
Locations
453 S Main St
Bourbonnais, IL 60914
Phone (815) 401-7260
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Fort Wayne, IN
- NPI 1417446022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421020800000",
"number": "1972908663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 S MAIN",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609141918",
"telephone_number": "815-401-7260",
"fax_number": "815-401-7267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 S MAIN",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609141918",
"telephone_number": "815-401-7260",
"fax_number": "815-401-7267"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINETIC O & P, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-24",
"last_updated": "2015-01-12",
"status": "A",
"authorized_official_last_name": "HAYS",
"authorized_official_first_name": "AARON",
"authorized_official_title_or_position": "PRESIDENT/CPO",
"authorized_official_telephone_number": "815-401-7260",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "IL",
"license": "213000210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.