Active NPI
Benjamin Aaron Fugitt, PT, DPT, CSCS
- Sports Physical Therapist
- Elkhorn, NE
National Provider Identifier
1275429086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 4827
- Practice address
- 20502 Roosevelt St
Elkhorn, NE 68022-4148 - Phone
- (402) 955-8181
- NPI assigned
- Jun 17, 2025
- Last updated
- Mar 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | ||
| Pediatric Physical Therapist | 2251P0200X | 4827 | NE | |
| Sports Physical Therapist | 2251S0007X | 4827 | NE | Primary |
| Orthopedic Physical Therapist | 2251X0800X | NU |
Addresses
Primary practice location
20502 Roosevelt St
Elkhorn, NE 68022-4148
Mailing address
111 S 38TH St Apt 240
Council Bluffs, IA 51501-3387
Phone (417) 425-0313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4827 | NE | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Specialty Physician Billing | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Nurse Practitioner
- Omaha, NE
- NPI 1013040369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1275429086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S 38TH ST APT 240",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515013387",
"telephone_number": "417-425-0313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20502 ROOSEVELT ST",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680224148",
"telephone_number": "402-955-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUGITT",
"first_name": "BENJAMIN",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-17",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NE",
"license": "4827",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "NE",
"license": "4827",
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.