NPIMap

Organization Active NPI

Summit Fitness & Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Brookfield, CT
National Provider Identifier
1649436700
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
008174 Issued in CT
Legal business name
SUMMIT FITNESS & REHABILITATION, LLC
Practice address
195 Federal Rd
Suite 6
Brookfield, CT 06804-2556
Phone
(203) 546-8648
NPI assigned
Jul 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Authorized official

Name
Mr. Adam Lee Granger, MSPT
Title
Sole Member
Phone
(203) 546-8648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 008174 CT Primary

Addresses

Primary practice location

195 Federal Rd
Suite 6
Brookfield, CT 06804-2556

Mailing address

195 Federal Rd
Suite 6
Brookfield, CT 06804-2556
Phone (203) 546-8648

Other identifiers 1

IdentifierTypeStateIssuer
020621971OtherCTTRICARE NORTH ID

National Provider Directory

National Provider Directory

Locations

195 Federal Rd
Ste 6
Brookfield, CT 06804
Phone (203) 546-8648

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1649436700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FEDERAL RD",
            "address_2": "SUITE 6",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042556",
            "telephone_number": "203-546-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FEDERAL RD",
            "address_2": "SUITE 6",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042556",
            "telephone_number": "203-546-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FITNESS & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "203-546-8648",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "008174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH ID",
            "identifier": "020621971",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.