Fortify Wellness and Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FORTIFY WELLNESS AND PHYSICAL THERAPY LLC

Practice address

14 Airport Park Rd
East Granby, CT 06026-9523

Phone

(860) 245-8914

Fax

(860) 957-2364

NPI assigned

May 8, 2024

Last updated

Apr 19, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devon Dusseault, DPTNPI 1861168437

Title

Owner/Director

Phone

(860) 245-8914

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

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.

• Devon Dusseault, PT, DPT

  • Physical Therapist
  • East Granby, CT
  • NPI 1861168437
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776556800000",
    "number": "1245088848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 AIRPORT PARK RD",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269523",
            "telephone_number": "860-245-8914",
            "fax_number": "860-957-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 AIRPORT PARK RD",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269523",
            "telephone_number": "860-245-8914",
            "fax_number": "860-957-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTIFY WELLNESS AND PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A",
        "authorized_official_last_name": "DUSSEAULT",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "860-245-8914",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellsworth Medical, LLC
• Maureen Elizabeth Emery, LCSW
• Edward M Ewald, MD
• Ellen Farmer Lanctot, DC
• Kristen Formanek, LCSW
• Elizabeth S Freedman, MD
• Khuram R Ghumman, MD, MPH, CPE, FAAFP
• Robert L Gordon, D.D.S.
• Healing Edge Medical Associates LLC
• Healing Solutions, LLC

• Physical Therapy Clinic/Center in East Granby, CT
• Providers in East Granby, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; 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.