NPIMap

Organization Active NPI

Lifetime Physical Therapy and Fitness Inc

Doing business as Lifetime Home Health and Wellness

  • Physical Therapy Clinic/Center
  • Yorba Linda, CA
National Provider Identifier
1649424425
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
LIFETIME PHYSICAL THERAPY AND FITNESS INC
Doing business as
Lifetime Home Health and Wellness
Practice address
5072 Stone Canyon Ave
Yorba Linda, CA 92886-4313
Phone
(714) 980-1835
Fax
(714) 701-0814
NPI assigned
Nov 6, 2008
Last updated
Dec 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Authorized official

Name
Mr. Robert William Stowell, MBA
Title
Secretary / Treasurer
Phone
(714) 980-1835

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5072 Stone Canyon Ave
Yorba Linda, CA 92886-4313

Mailing address

5072 Stone Canyon Ave
Yorba Linda, CA 92886-4313
Phone (714) 980-1835

Other names 1

  • Lifetime Home Health and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090501000484 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8224186184 Receives reassigned benefits from 8 practitioners
Practice locations: Yorba Linda, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1649424425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5072 STONE CANYON AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864313",
            "telephone_number": "714-980-1835",
            "fax_number": "714-701-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5072 STONE CANYON AVE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864313",
            "telephone_number": "714-980-1835",
            "fax_number": "714-701-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME PHYSICAL THERAPY AND FITNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "STOWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "SECRETARY / TREASURER",
        "authorized_official_telephone_number": "714-980-1835",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Home Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.