Form Fix LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FORM FIX LLC

Practice address

173 Washington St
Morristown, NJ 07960-3789

Phone

(201) 306-2532

NPI assigned

Sep 8, 2021

Organization subpart

No

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

Authorized official

Name

Jonathan Crawford, PT, DPTNPI 1245587708

Title

Owner, Physical Therapist

Phone

(201) 306-2532

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.

• Jonathan M Crawford, DPT

  • Physical Therapist
  • Morristown, NJ
  • NPI 1245587708
  NPD Authorized official

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1396414835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 LAKE AVE APT 3",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662745",
            "telephone_number": "201-306-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 WASHINGTON ST",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079603789",
            "telephone_number": "201-306-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM FIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "201-306-2532",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Footprints Orthotic Services, Inc.
• Diana Forand-Pike, LCSW
• Caitlin Nicole Ford, LAC
• Emily Theresa Forester, DO
• Joseph Forgione, MD
• Marcella Fornari, DO
• Fort Health Medical Group of New Jersey, P.C.
• Brenda G. Forte, LCSW
• Rita Fowler, PT
• Katherine Fox, MD

• Physical Therapy Clinic/Center in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

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