Physical Therapy Fit for Life Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY FIT FOR LIFE INC

Practice address

6410 Delvin Cir
Leland, NC 28451-1778

Phone

(516) 652-6880

Fax

(910) 833-5026

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Authorized official

Name

Gerard Desmond, PTNPI 1710951637

Title

Owner

Phone

(516) 652-6880

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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

• Gerard C Desmond, DPT

  • Physical Therapist
  • New York, NY
  • NPI 1710951637

  NC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1366118861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 DELVIN CIR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511778",
            "telephone_number": "516-652-6880",
            "fax_number": "910-833-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 DELVIN CIR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511778",
            "telephone_number": "516-652-6880",
            "fax_number": "910-833-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY FIT FOR LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "DESMOND",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-652-6880",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace Be Still Home Care LLC
• Amber Perry
• Hannah Grace Perryman, PT, DPT
• Shannon Bardin Phelps, F.N.P.
• Andrew Phillips
• Danielle Rae Pierce, PHARMD
• John Gregory Player, MD
• Kristin Jean Pleasant, FNP-C
• Joanna Kaitlin Plymon
• Anne Marie Policella, M.A. CCC-SLP

• Physical Therapist in Leland, NC
• Providers in Leland, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.