NPIMap

Organization Active NPI

Lifespeed Physical Therapy and Fitness

  • Physical Therapist
  • Sussex, WI
National Provider Identifier
1366535742
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6020-024 Issued in WI
Legal business name
LIFESPEED PHYSICAL THERAPY AND FITNESS
Practice address
N64W24678 Main St
Suite B
Sussex, WI 53089
Phone
(262) 820-2686
Fax
(866) 245-8064
NPI assigned
Sep 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Larry D BriandNPI 1275573198
Title
Co-Owner
Phone
(877) 552-2996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6020-024 WI Primary

Addresses

Primary practice location

N64W24678 Main St
Suite B
Sussex, WI 53089

Mailing address

8700 Durand Ave
Suite D
Sturtevant, WI 53177
Phone (877) 552-2996

National Provider Directory

National Provider Directory

Locations

N64W24678 Main St
Sussex, WI 53089
Phone (262) 246-9312

N64W24678 Main St
Ste B
Sussex, WI 53089
Phone (262) 820-2686

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366535742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 DURAND AVE",
            "address_2": "SUITE D",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "53177",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N64W24678 MAIN ST",
            "address_2": "SUITE B",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "53089",
            "telephone_number": "262-820-2686",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPEED PHYSICAL THERAPY AND FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRIAND",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "877-552-2996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6020-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.