Physical Life LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PHYSICAL LIFE LLC

Practice address

850 Hampton Rd
McDonough, GA 30253-6514

Phone

(678) 272-0464

NPI assigned

Sep 8, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Trevino Simmons, DNP, FNPNPI 1346797065

Title

Owner

Phone

(770) 380-9756

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Trevino C Simmons, FNP

  • Family Nurse Practitioner
  • Ellenwood, GA
  • NPI 1346797065
  NPD Authorized official

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1386524437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 BARCLAY DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528035",
            "telephone_number": "678-272-0464",
            "fax_number": "678-272-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HAMPTON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536514",
            "telephone_number": "678-272-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TREVINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-380-9756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.