NPIMap

Organization Active NPI

Five Star Rehabilitation and Wellness Services, LLC

Doing business as Ageility Physical Therapy Solutions at 75 State Street

  • Physical Therapy Clinic/Center
  • Portland, ME
National Provider Identifier
1184378333
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC
Doing business as
Ageility Physical Therapy Solutions at 75 State Street
Practice address
75 State St
Portland, ME 04101-3746
Phone
(207) 775-7775
NPI assigned
Feb 7, 2022
Last updated
Feb 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Katherine E. Potter
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

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

Addresses

Primary practice location

75 State St
Portland, ME 04101-3746

Mailing address

75 State St
Portland, ME 04101-3746
Phone (207) 775-7775

Other names 1

  • Ageility Physical Therapy Solutions at 75 State Street Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Five Star Rehabilitation and Wellness Services LLC7 organizations share this tax ID, including this one
Part of
Five Star Rehabilitation and Wellness Services LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1184378333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013746",
            "telephone_number": "207-775-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013746",
            "telephone_number": "207-775-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at 75 State Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.