Longevity Health and Fitness, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LONGEVITY HEALTH AND FITNESS, INC.

Practice address

1150 N 5TH Ave Ste B2
St Charles, IL 60174-1277

Phone

(331) 248-0695

Fax

(331) 240-1333

NPI assigned

Jan 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Robert C. Gregory, DCNPI 1205137627

Title

Owner/President

Phone

(331) 248-0695

Specialties & licenses 1

Addresses

Other names 1

• Longevity Health and Fitness Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Robert Gregory, DC

  • Chiropractor
  • St Charles, IL
  • NPI 1205137627
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1639700776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 5TH AVE STE B2",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741277",
            "telephone_number": "331-248-0695",
            "fax_number": "331-240-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 5TH AVE STE B2",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741277",
            "telephone_number": "331-248-0695",
            "fax_number": "331-240-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY HEALTH AND FITNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "331-248-0695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longevity Health and Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Lombardo, BCBA, IBA
• Katherine London
• Dennis A. Long, M.D.
• Melanie Elizabeth Long
• Robert Wayne Long, D.O.
• Longevity Strength and Wellness Center LLC
• Christian Lopez, DPT
• Giuseppe Lorusso, RBT
• Melissa Ann Lose, L.C.S.W., C.A.D.C.
• Lotus Behavioral Wellness

• Chiropractor in St Charles, IL
• Providers in St Charles, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.