KINETIC SPORTS MEDICINE AND PERFORMANCE LLC (NPI# 1083101117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083101117 |
| Entity Type | Organization |
| Organization Name | KINETIC SPORTS MEDICINE AND PERFORMANCE LLC |
| Other Organization Name | KINETIC SPORTS MEDICINE AND PERFORMANCE |
| Practice Address |
665 S 72nd St Milwaukee WI 53214-1558 |
| Mailing Address |
N29w29682 Franciscan Rd Pewaukee WI 53072-3208 |
| Practice Telephone | 2146876775 |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2018-04-14 |
| Authorized Official Name | MICHAEL FALK (OWNER, PRESIDENT) |
| Authorized Official Telephone | 2146876775 |
| Authorized Official Credential | PT, DPT, ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
14121-24 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kinetic Sports Medicine and Performance | Doing Business As Name - Organization |
| Street Address |
665 S 72ND ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53214-1558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740740208 | Melanie Figueroa | Counselor | West Milwaukee Ctc, 1610 Miller Park Way, West Milwaukee, WI 53214 | 2019-03-21 |
| 1619403011 | Lea Salome Denny | Counselor | 8626b W Greenfield Ave, Suite B300, West Allis, WI 53214 | 2017-05-04 |
| 1891148318 | West Allis Prescription Center Inc | Pharmacy | 6737 W Washington Ave, Suite 1100, West Allis, WI 53214 | 2016-07-20 |
| 1316390495 | Kristina Overlee | Nurse Practitioner | 6737 W. Washington Street, Suite 2150, West Allis, WI 53214 | 2016-07-13 |
| 1801239843 | Daniel Anthony Cichy | Pharmacist | 10101 W Greenfield Ave Ste 130, West Allis, WI 53214 | 2013-04-09 |
| 1295072544 | Wisconsin Vision, Inc. | Optometrist | 1220 Miller Park Way, West Milwaukee, WI 53214 | 2013-01-07 |
| 1831457720 | Kevin Konieczka | Physical Therapist | 1224 Miller Parkway, Milwaukee, WI 53214 | 2012-04-27 |
| 1497031843 | Jill Elizabeth Gerou | Registered Nurse | 8420 West Greenfield Ave, Apartment #7, West Allis, WI 53214 | 2011-10-31 |
| 1700176815 | Carolyn Hasek | Counselor | 1126 S 70th St Ste 112-113, West Allis, WI 53214 | 2011-04-10 |
| 1972802775 | Barbara Smith | Licensed Practical Nurse | 651 S 63 St, Apt1, Milwaukee, WI 53214 | 2011-03-18 |
| Find all providers in zip 53214 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861979445 | Summit Wellness, Inc. | Clinic/Center | 301 E Reservoir Ave Ste 1, Milwaukee, WI 53212-3743 | 2018-07-25 |
| 1548511975 | Be Well Therapeutic Massage, LLC | Clinic/Center | 2834 N 62nd St, Milwaukee, WI 53210-2117 | 2012-09-25 |
| 1750530812 | A Step Ahead Physical Therapy Services | Clinic/Center | 2915 S Kinnickinnic Ave, Milwaukee, WI 53207-2518 | 2008-09-15 |
| 1881643005 | Kerk Physical Therapy Specialists Sc | Clinic/Center | 807 N Jefferson St, Milwaukee, WI 53202 | 2006-05-06 |
| 1245238906 | United Therapy Services, Inc. | Clinic/Center | 3209 S Lake Dr, Milwaukee, WI 53235-3712 | 2005-07-07 |
| 1912565771 | Cameo Nursing Home, LLC | Clinic/Center | 5790 S 27th St, Milwaukee, WI 53221-4129 | 2019-06-05 |
| 1255834800 | Occupational Heath Centers of The Southwest Pa | Clinic/Center | 11414 W Park Pl Ste 100, Milwaukee, WI 53224-3500 | 2018-03-09 |
| 1578015889 | Mindful Matters Wellness, LLC | Clinic/Center | 1845 N Farwell Ave, Ste 200, Milwaukee, WI 53202-1793 | 2016-11-03 |
| 1508258526 | Quad Medical | Clinic/Center | 633 E Mason St, Milwaukee, WI 53202-3813 | 2015-02-27 |
| 1003040601 | Michael Jerome Wright Sr. | Clinic/Center | 2020 W Wells St, Milwaukee, WI 53233-2720 | 2009-05-11 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on KINETIC SPORTS MEDICINE AND PERFORMANCE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.