Defined Fitness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121001 Issued in NM

Legal business name

DEFINED FITNESS, LLC

Doing business as

Defined Wellness LLC

Practice address

4930 McLeod Rd NE
Albuquerque, NM 87109-2118

Phone

(505) 349-4444

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Laura George

Title

Cfo

Phone

(505) 349-4444

Specialties & licenses 1

Addresses

Other names 1

• Defined Wellness LLC Doing business as

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1366803561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 MCLEOD RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092118",
            "telephone_number": "505-349-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 MCLEOD RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092118",
            "telephone_number": "505-349-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFINED FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "505-349-4444"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "121001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Defined Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel L Defazio, DDS
• Debbie Defazio
• Kimberly Defazio
• Richard Peter Defelice, DC DOM
• Anthony Defilippo
• Hilda Solange Defoe Payne
• Jason Michael Degani, MD
• Lauren Schneider Degory, DPT
• Ann L Dehart, MD
• Corinna Deherrera

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.