KICK SOME MASS LLC NPI 1841673928

NPI Information

  • NPI: 1841673928
  • Provider Name: KICK SOME MASS, LLC
  • Classification: Physical Medicine & Rehabilitation - 2081S0010X
  • Specialization: Sports Medicine
  • Entity Type: Organization
  • Address: 316 PARKRIDGE AVE
    ORANGE PARK, FL
    ZIP 32065
  • Phone: (904) 589-0750

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NPI Details

KICK SOME MASS, LLC is a sports medicine physical medicine rehabilitation in Orange Park, FL. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. KICK SOME MASS, LLC NPI is 1841673928. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

316 PARKRIDGE AVE
ORANGE PARK, FL
ZIP 32065-507
Phone: (904) 589-0750

The provider's authorized official is Jeffrey Allyn Ruterbusch .
The authorized official title is Medical Director and has the following contact phone number (904) 505-0628.

The enumeration date for this NPI number is 7/7/2015 and was last updated on 10/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133NN1002XNutritionistNutrition, EducationNo
22083B0002XPreventive MedicineObesity MedicineNo
32083A0100XPreventive MedicineAerospace MedicineNo
42081S0010XPhysical Medicine & RehabilitationSports MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1IP327AOTHERFLORIDAPTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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