Organization Active NPI

Fit Club Inc

  • Orthopedic Physical Therapist
  • New York, NY
National Provider Identifier
1225570807
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
037024 Issued in NY
Legal business name
FIT CLUB INC
Practice address
164 W 25TH St
Ground Floor
New York, NY 10001-7400
Phone
(646) 875-8348
NPI assigned
Nov 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Authorized official

Name
Kellen Scantlebury, PT, DPT, CSCSNPI 1326477498
Title
Owner
Phone
(516) 849-7989

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 037024 NY Primary

Addresses

Primary practice location

164 W 25TH St
Ground Floor
New York, NY 10001-7400

Mailing address

3243 44TH St Apt 1F
Astoria, NY 11103-2339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180308000315 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385905348 Receives reassigned benefits from 7 practitioners
Practice locations: New York, NY; Astoria, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

203 Berry St
Brooklyn, NY 11249
Phone (646) 875-8348

164 W 25th St
New York, NY 10001
Phone (646) 875-8348

153 W 27th St
Ste 1201
New York, NY 10001

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1225570807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 44TH ST APT 1F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W 25TH ST",
            "address_2": "GROUND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017400",
            "telephone_number": "646-875-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIT CLUB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "SCANTLEBURY",
        "authorized_official_first_name": "KELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-849-7989",
        "authorized_official_credential": "PT, DPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "037024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.