NPIMap

Organization Active NPI

Fitlife Fitness & Aquatics, Incorporated

  • Physical Therapy Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1124105473
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
186190 Issued in PA
Legal business name
FITLIFE FITNESS & AQUATICS, INCORPORATED
Practice address
7140 Germantown Ave
Philadelphia, PA 19119-1843
Phone
(215) 753-9034
Fax
(215) 753-9035
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kelly Snyder
Title
Billing Agent
Phone
(610) 282-4239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 186190 PA Primary

Addresses

Primary practice location

7140 Germantown Ave
Philadelphia, PA 19119-1843

Mailing address

7140 Germantown Ave
Philadelphia, PA 19119-1843
Phone (215) 753-9034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330000452 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3971595265 Receives reassigned benefits from 18 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

7140 Germantown Ave
Philadelphia, PA 19119
Phone (215) 753-8910

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124105473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191191843",
            "telephone_number": "215-753-9034",
            "fax_number": "215-753-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191191843",
            "telephone_number": "215-753-9034",
            "fax_number": "215-753-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITLIFE FITNESS & AQUATICS, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "610-282-4239",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "186190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.