Fitness Sports and Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0079921 Issued in NY

Legal business name

FITNESS SPORTS AND PHYSICAL THERAPY PC

Practice address

4063 N Buffalo St
Orchard Park, NY 14127-2442

Phone

(716) 662-2949

Fax

(716) 662-3673

NPI assigned

Mar 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Terry John Whieldon, PHYSICAL THERAPIST

Title

President Physical Therapist

Phone

(716) 662-2949

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499385600000",
    "number": "1558322784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4063 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272442",
            "telephone_number": "716-662-2949",
            "fax_number": "716-662-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272442",
            "telephone_number": "716-662-2949",
            "fax_number": "716-662-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS SPORTS AND PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2017-07-07",
        "status": "A",
        "authorized_official_last_name": "WHIELDON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "716-662-2949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0079921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "006103111",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9352186",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVEX",
            "identifier": "00011189901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Finotti
• Deborah Fiore
• Dawn J. Fischer, PT
• David Michael Fisher
• Bobbijo Fitch, MS IN ED, CCC, SLP
• John Patrick Fitzgerald, MD
• Sarah Fitzgerald, LMSW
• Chester Arthur Fleischman, RPH
• Michael John Foley, DDS
• Laura Louise Ford-Mukkamala, DO

• Physical Therapist in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; 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.