Medical Fitness Clinic of Kerrville

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

Legal business name

MEDICAL FITNESS CLINIC OF KERRVILLE

Practice address

1337 Bandera Hwy
Kerrville, TX 78028-9555

Phone

(210) 569-4129

NPI assigned

Nov 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Byron Keith Black, PH.D, CEPNPI 1255673422

Title

Manager/Owner

Phone

(210) 569-4129

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Byron Keith Black, PH.D., RCEP

  • Clinical Exercise Physiologist
  • Kerrville, TX
  • NPI 1255673422
  NPD Authorized official

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1386309276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 RIVER TRAIL RD",
            "city": "PIPE CREEK",
            "state": "TX",
            "postal_code": "780635979",
            "telephone_number": "210-569-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 BANDERA HWY",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780289555",
            "telephone_number": "210-569-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FITNESS CLINIC OF KERRVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "BYRON",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "210-569-4129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, CEP"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "byron@mfcok.com",
            "affiliation": "N",
            "address_1": "1337 Bandera Hwy",
            "city": "Kerrville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780289555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Exercise Physiologist in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Clinical Exercise Physiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.