Five Star Rehabilitation and Wellness Services, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC

Doing business as

Ageility Physical Therapy Solutions at 75 State Street

Practice address

75 State St
Portland, ME 04101-3746

Phone

(207) 775-7775

NPI assigned

Feb 28, 2022

Organization subpart

Yes

Parent organization

FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Jeffrey C. Leer

Title

President & Chief Executive Officer

Phone

(617) 796-8350

Specialties & licenses 1

Addresses

Other names 1

• Ageility Physical Therapy Solutions at 75 State Street Doing business as

Part of

Five Star Rehab

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1639825631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WASHINGTON ST # 230",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581726",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013746",
            "telephone_number": "207-775-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at 75 State Street",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ageility Physical Therapy Solutions at 75 State Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• June Fitzpatrick, PA-C
• Sean M Fitzpatrick, LCSW
• Shannon Catherine Fitzpatrick, RN
• Phyllis Fitzsimmons-Luce, LCPC, LMHC
• Five Star Rehabilitation and Wellness Services, LLC (Ageility Physical Therapy Solutions at 75 State Street)
• Megan L Fix, MD
• Carly G Flagg, CADC
• Michele L Flagg, LMSW-CONDITIONAL
• Lawrence Louis Flaherty, DMD
• Kelly Flanagan, M.A., CF-SLP

• Physical Therapy Clinic/Center in Portland, ME
• Providers in Portland, ME by specialty
• Physical Therapy Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.