Fit Kidz Obesity Center LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

FIT KIDZ OBESITY CENTER LLC

Practice address

2621 Maple Point Dr
Lafayette, IN 47905-5159

Phone

(765) 430-4710

NPI assigned

Feb 3, 2010

Organization subpart

No

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

Authorized official

Name

Mr. James E Kelly

Title

Registered Agent

Phone

(765) 430-4710

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1235461054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 MAPLE POINT DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 MAPLE POINT DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055159",
            "telephone_number": "765-430-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIT KIDZ OBESITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "765-430-4710",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathryn Flannery
• Grace Fleetwood, RBT
• Myra Louise Fleetwood, MA

• Health Maintenance Organization in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Health Maintenance Organization in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.