NPIMap

Organization Active NPI

Movement Connection LLC

Doing business as CrossFit 696

  • Health & Wellness Coach
  • Gardner, MA
National Provider Identifier
1417815655
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Legal business name
MOVEMENT CONNECTION LLC
Doing business as
CrossFit 696
Nutrition & CrossFit 696
Practice address
696 W Broadway
Gardner, MA 01440-2809
Phone
(978) 204-2786
NPI assigned
Jan 15, 2026
Last updated
Jan 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Colleen BogonovichNPI 1356200166
Title
Operations Manager
Phone
(508) 783-5597

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Health Educator 174H00000X NU
Health & Wellness Coach 171400000X NU Primary

Addresses

Primary practice location

696 W Broadway
Gardner, MA 01440-2809

Mailing address

80 Allen St
Gardner, MA 01440-1922
Phone (978) 204-2786

Other names 2

  • CrossFit 696 Doing business as
  • Nutrition & CrossFit 696 Doing business as

National Provider Directory

National Provider Directory

Locations

696 W Broadway
Gardner, MA 01440
Phone (978) 204-2786

Practitioners & affiliated clinicians

Practitioners 1

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": "1768435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1417815655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ALLEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401922",
            "telephone_number": "978-204-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 W BROADWAY",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014402809",
            "telephone_number": "978-204-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOVEMENT CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "BOGONOVICH",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "508-783-5597"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CrossFit 696",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nutrition & CrossFit 696",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardner, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.