Organization Active NPI

Energized Fitness, LLC

  • Acupuncturist
  • Phoenix, AZ
National Provider Identifier
1508490624
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
ENERGIZED FITNESS, LLC
Doing business as
Energized Health Solutions
Practice address
16421 N Tatum Blvd Ste 210
Phoenix, AZ 85032-3457
Phone
(602) 767-2737
NPI assigned
Feb 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Derek MarrongelleNPI 1417581539
Title
President
Phone
(602) 767-2737

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

16421 N Tatum Blvd Ste 210
Phoenix, AZ 85032-3457

Mailing address

113 Pine Creek Dr
Orwigsburg, PA 17961-9135
Phone (570) 617-9005

Other practice location 1

113 Pine Creek Dr
Orwigsburg, PA 17961-9135
Phone (570) 617-9005

Other names 1

  • Energized Health Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

1818 E Southern Ave
Ste 20A
Mesa, AZ 85204

16421 N Tatum Blvd
Ste 210
Phoenix, AZ 85032
Phone (570) 617-9005

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1508490624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PINE CREEK DR",
            "city": "ORWIGSBURG",
            "state": "PA",
            "postal_code": "179619135",
            "telephone_number": "570-617-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16421 N TATUM BLVD STE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323457",
            "telephone_number": "602-767-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Pine Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Orwigsburg",
            "state": "PA",
            "postal_code": "179619135",
            "country_code": "US",
            "telephone_number": "570-617-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENERGIZED FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "MARRONGELLE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-767-2737"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Energized Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Energized Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.