NPIMap

Organization Active NPI

Fearless Functional Fitness, LLC

  • Physical Therapist
  • San Marcos, TX
National Provider Identifier
1063974152
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FEARLESS FUNCTIONAL FITNESS, LLC
Practice address
324 Riverwalk Dr Ste 312
San Marcos, TX 78666-6936
Phone
(512) 268-9130
Fax
(833) 437-4389
NPI assigned
Apr 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nicole Elizabeth Laird, PT, DPTNPI 1275880486
Title
Owner, Physical Therapist
Phone
(512) 730-9600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

324 Riverwalk Dr Ste 312
San Marcos, TX 78666-6936

Mailing address

324 Riverwalk Dr Ste 312
San Marcos, TX 78666-6936
Phone (512) 268-9130

Other names 1

  • Hays County Physical Therapy and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

140 Kirkham Cir
Kyle, TX 78640

324 Riverwalk Dr
Ste 312
San Marcos, TX 78666
Phone (512) 268-9130

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1063974152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 RIVERWALK DR STE 312",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666936",
            "telephone_number": "512-268-9130",
            "fax_number": "833-437-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 RIVERWALK DR STE 312",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666936",
            "telephone_number": "512-268-9130",
            "fax_number": "833-437-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEARLESS FUNCTIONAL FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "LAIRD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "512-730-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hays County Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hays County Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.

Verify at the official NPI Registry.