Active NPI
Lions United Fitness Center
- Developmentally Disabled Services Day Training Agency
- Mendota Heights, MN
National Provider Identifier
1023742350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- LIONS UNITED FITNESS CENTER
- Practice address
- 2535 Pilot Knob Rd Ste 126
Mendota Heights, MN 55120-1170 - Phone
- (651) 348-7278
- NPI assigned
- Jul 12, 2022
- 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
- Andrew Robert Cameron
- Title
- Life Coach
- Phone
- (651) 348-7278
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary | ||
| Developmental Disabilities Clinic/Center | 261QD1600X | |||
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
2535 Pilot Knob Rd Ste 126
Mendota Heights, MN 55120-1170
Mailing address
2535 Pilot Knob Rd Ste 126
Mendota Heights, MN 55120-1170
Phone (651) 348-7278
National Provider Directory
National Provider DirectoryLocations
2535 Pilot Knob Rd
Ste 126
Mendota Heights, MN 55120
Phone (651) 348-7278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657584000000",
"number": "1023742350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2535 PILOT KNOB RD STE 126",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551201170",
"telephone_number": "651-348-7278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2535 PILOT KNOB RD STE 126",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551201170",
"telephone_number": "651-348-7278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIONS UNITED FITNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A",
"authorized_official_last_name": "CAMERON",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "ROBERT",
"authorized_official_title_or_position": "LIFE COACH",
"authorized_official_telephone_number": "651-348-7278"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mendota Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.