FL Performance,LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

14105 Issued in AL

Legal business name

FL PERFORMANCE,LLC

Doing business as

PhysIQ Lifestyle Medicine

Practice address

3125 Independence Dr
Suite 300A1
Homewood, AL 35209-4159

Phone

(205) 802-5949

NPI assigned

Nov 13, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kim Fagan, M.D.

Title

Owner/Medical Director

Phone

(205) 874-9940

Specialties & licenses 1

Addresses

Other names 1

• PhysIQ Lifestyle Medicine Doing business as

Locations

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1326444795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DR",
            "address_2": "SUITE 300A1",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352094159",
            "telephone_number": "205-802-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DR",
            "address_2": "SUITE 300A1",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352094159",
            "telephone_number": "205-802-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FL PERFORMANCE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "205-874-9940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "14105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PhysIQ Lifestyle Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Feagin, DMD, MS
• Emily Dolbare Feely, MD
• Joan Janelle Ferguson, RD, LD
• Porschia Tiajuana Fisher, LPC
• Mary Ben Fitts, PT
• Taylor R Flannagan, D.C
• Dominque Forte, DPT
• Frank Larussa Optometry LLC
• Freds Stores of Tennessee Inc (Drugs for Less 1781)
• Mary Lynn Freeman

• Specialist in Homewood, AL
• Providers in Homewood, AL by specialty
• Specialist in Alabama

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