NPIMap

Organization Active NPI

Laboratory Fitness, LLC

  • Physical Therapy Clinic/Center
  • Peachtree City, GA
National Provider Identifier
1043969264
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
LABORATORY FITNESS, LLC
Practice address
401 Dividend Dr Ste K
Peachtree City, GA 30269-1939
Phone
(678) 506-1236
Fax
(866) 635-2795
NPI assigned
Mar 23, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Brandon Hannon
Title
Ceo
Phone
(678) 506-1236

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20240731002517 GA Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1052858628 Practice locations: Peachtree City, GA
O20240821000736 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052858628 Receives reassigned benefits from 2 practitioners
Practice locations: Peachtree City, GA

National Provider Directory

National Provider Directory

Locations

1001 Moba Dr
Ste A
Peachtree City, GA 30269
Phone (678) 506-1236

611 Highway 74 S
Ste 300
Peachtree City, GA 30269

1001 Moba Dr
Peachtree City, GA 30269

401 Dividend Dr
Ste K
Peachtree Cty, GA 30269
Phone (678) 506-1236

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

NPPES NPI Registry

Primary practice location

401 Dividend Dr Ste K
Peachtree City, GA 30269-1939

Mailing address

401 Dividend Dr Ste K
Peachtree City, GA 30269-1939
Phone (678) 506-1236

Other names 1

NPPES NPI Registry
  • Lab Fit Physical Therapy and Wellness Center, LLC Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2024.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1043969264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DIVIDEND DR STE K",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691939",
            "telephone_number": "678-506-1236",
            "fax_number": "866-635-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DIVIDEND DR STE K",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691939",
            "telephone_number": "678-506-1236",
            "fax_number": "866-635-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORY FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "HANNON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-506-1236"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lab Fit Physical Therapy and Wellness Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.

Verify at the official NPI Registry.