Fitness Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5133156-2401 Issued in UT

Legal business name

FITNESS REHAB LLC

Doing business as

Personal Fitness Systems Physical Therapy

Practice address

3089 N Canyon Rd
Provo, UT 84604-3920

Phone

(801) 375-6500

Fax

(801) 375-6505

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

James Charles Nackos, DPTNPI 1568483238

Title

Owner

Phone

(801) 375-6500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Personal Fitness Systems Physical Therapy Doing business as

Locations

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.

• James C Nackos, MPT

  • Physical Therapist
  • Provo, UT
  • NPI 1568483238
  NPD (past) Authorized official

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1427121607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "888-700-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3089 N CANYON RD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043920",
            "telephone_number": "801-375-6500",
            "fax_number": "801-375-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "NACKOS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-375-6500",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "5133156-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51331562400001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Fitness Systems Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Smith Fisher
• Nicole Fisher, SSW
• Rodney L Fisher, CRNA
• Shawna Marie Fisher, SSW
• Tori Fisher
• David Ammon Fitzgerald
• Kristie A Fitzgerald, B.S., PHARM
• Shelby Ann Fitzgerald
• Mary Beth Fitzpatrick, PHD
• Neil Harman Curtis Flack

• Physical Therapist in Provo, UT
• Providers in Provo, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.