Personal Fitness and Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PERSONAL FITNESS AND REHABILITATION LLC

Practice address

12101 Sycamore Station PL
Louisville, KY 40299-5190

Phone

(814) 574-6070

NPI assigned

Dec 12, 2017

Last updated

Jan 24, 2018By 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

Brad Johnson

Title

Ceo

Phone

(814) 574-6070

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1316452451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 SYCAMORE STATION PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 SYCAMORE STATION PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995190",
            "telephone_number": "814-574-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL FITNESS AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-574-6070"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Louisville, KY
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.