Precision Physical Medicine, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

CH11936 Issued in FL

Legal business name

PRECISION PHYSICAL MEDICINE, LLC

Doing business as

Complete Physical Medicine, LLC

Practice address

6811 Porto Fino Cir
Fort Myers, FL 33912-4354

Phone

(239) 288-2218

Fax

(239) 791-5526

NPI assigned

Nov 8, 2017

Last updated

Dec 13, 2017By 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

Dr. James Bolger, DCNPI 1720525082

Title

Owner

Phone

(239) 908-0899

Specialties & licenses 2

Addresses

Other names 1

• Complete Physical Medicine, LLC Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Lehigh Accident Care, LLC

  • Rehabilitation Clinic/Center
  • Lehigh Acres, FL
  • NPI 1235642711
  NPPES parent name

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.

• James Bolger

  • Chiropractor
  • Aspen, CO
  • NPI 1720525082
  NPD Authorized official

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1306359617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151850",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339151850",
            "telephone_number": "239-908-0899",
            "fax_number": "239-791-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 PORTO FINO CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124354",
            "telephone_number": "239-288-2218",
            "fax_number": "239-791-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "BOLGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-908-0899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "CH11936",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Physical Medicine, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.