Meltdown Fitness Atlanta, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MELTDOWN FITNESS ATLANTA, LLC

Practice address

3983 Lavista Rd Ste 128
Tucker, GA 30084-5151

Phone

(833) 887-3422

NPI assigned

Sep 9, 2020

Organization subpart

No

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

Authorized official

Name

Stanford James MaddoxNPI 1528553716

Title

Owner

Phone

(770) 899-6364

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rehab and Beyond Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanford James Maddox

  • Contractor
  • Snellville, GA
  • NPI 1528553716

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1346855160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 OAK RD UNIT 815",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300781905",
            "telephone_number": "833-887-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3983 LAVISTA RD STE 128",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845151",
            "telephone_number": "833-887-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELTDOWN FITNESS ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "STANFORD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-899-6364"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab and Beyond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medlife Medical Supply LLC
• Meena H. Mehta
• Meena Harshad Mehta, DDS
• Neema Shah Mehta, P.T.
• Fabian Rafael Mejias
• Sarah Elizabeth Melvin
• Eugia Littlejohn Meminger, PH.D
• Simone Mendez
• Betsnat Mengesha
• Ruth Mengesha

• Physical Therapist in Tucker, GA
• Providers in Tucker, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.