Ewellness Corporation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EWELLNESS CORPORATION

Practice address

747 3Rd Ave
New York, NY 10017-2803

Phone

(310) 915-6100

NPI assigned

Jul 3, 2014

Organization subpart

No

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

Authorized official

Name

Darwin Fogt, MPT

Title

Ceo

Phone

(310) 915-6100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1306252986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 CULVER BLVD # 217",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937704",
            "telephone_number": "310-915-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172803",
            "telephone_number": "310-915-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EWELLNESS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "FOGT",
        "authorized_official_first_name": "DARWIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-915-6100",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.