Lifestyle Therapeutix

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PTH4539 Issued in AL

Legal business name

LIFESTYLE THERAPEUTIX

Practice address

4825 University SQ
Suite 9
Huntsville, AL 35816-1826

Phone

(256) 348-2144

NPI assigned

Aug 3, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Edward Titus Goodman III, PTNPI 1801988910

Title

Owner

Phone

(256) 348-2144

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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.

• Edward Titus Goodman III, PT

  • Physical Therapist
  • Huntsville, AL
  • NPI 1801988910
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1316323314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 OSCAR PATTERSON RD",
            "city": "NEW MARKET",
            "state": "AL",
            "postal_code": "357619418",
            "telephone_number": "256-348-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 UNIVERSITY SQ",
            "address_2": "SUITE 9",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358161826",
            "telephone_number": "256-348-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE THERAPEUTIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "TITUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-348-2144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AL",
            "license": "PTH4539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Licht, M.D.
• Kyanna Leigh Lieber
• Life Aligned Counseling, LLC
• Life Quest Counseling and Wellness LLC
• Life Seasons Counseling Services, LLC
• Lifetime Behavioral Services
• Timeisha Marie Liggins
• Light and Love Counseling Group LLC
• Deborah A Light, CRNP
• James R Light, M.D.

• Physical Therapy Clinic/Center in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Physical Therapy Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.