Champion Fitness, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CHAMPION FITNESS, INC

Practice address

1015 S Mercer Ave
Bloomington, IL 61701-7107

Phone

(309) 663-6777

Fax

(309) 663-6779

NPI assigned

Apr 14, 2015

Last updated

Apr 14, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

CHAMPION FITNESS, INCAs reported in NPPES

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

Authorized official

Name

Michael Cohlman

Title

Ceo

Phone

(815) 844-5411

Specialties & licenses 1

Addresses

Part of

Champion Fitness

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Champion Fitness Inc

  • Physical Therapy Clinic/Center
  • Pontiac, IL
  • NPI 1407801012
  NPPES parent name

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1639565971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 W CUSTER AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641067",
            "telephone_number": "815-844-5411",
            "fax_number": "815-844-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107",
            "telephone_number": "309-663-6777",
            "fax_number": "309-663-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION FITNESS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHAMPION FITNESS, INC",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "COHLMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-844-5411"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Chall
• Stacy Chalmers, MS CCCA
• C. Elizabeth Chamberlain-Lane, SLP
• Diane Chamberlin, B.S.
• Elise Noelle Champanhet
• Jamie Elizabeth Champion
• Champions Heart Oasis LLC
• Bruce Chandler, MD
• Payton Chandler, SLP
• Chelsie Jo Chaney, M.S. CCC-SLP

• Physical Therapy Clinic/Center in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.