Fitness Elite Physical Therapy LLC
Organization Active NPI Physical Therapist · Newport, VT
NPI 1487370102 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1487370102
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- FITNESS ELITE PHYSICAL THERAPY LLC
- Practice address
- 637 Union St
Newport, VT 05855-5498 - Phone
- (802) 334-7177
- NPI assigned
- Oct 14, 2022
- Organization subpart
- No
Authorized official
- Name
- Shawn Moore, DPT
- Title
- Physical Therapist
- Phone
- (508) 863-0843
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221213000823 | VT | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3375912488 |
Receives reassigned benefits from 1 practitioner Practice locations: Newport, VT |
National Provider Directory
Locations
637 Union St
Newport, VT 05855
Phone (802) 334-7177
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
637 Union St
Newport, VT 05855-5498
Mailing address
PO Box 218
Derby, VT 05829-0218
Other providers in Newport, VT
- Lisa Erwin
- Family Infant and Toddler Program
- Karlene Farnsworth
- Alyssa Fay
- Jane Deering Fish
- Douglas Alan Flint
- Debra Folsom
- Laurie Ann Fontaine
- Cynthia L Fort
- Francis L Pinard OD PC
All providers in Newport, VT · Physical Therapist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.