NPIMap

Organization Active NPI

Custom Fit Physical Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Auburn, ME
National Provider Identifier
1659036382
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CUSTOM FIT PHYSICAL THERAPY & WELLNESS
Practice address
10 W Bates St
Auburn, ME 04210-6270
Phone
(207) 590-6312
NPI assigned
Nov 8, 2021
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Jennifer Frazier, PTNPI 1699922955
Title
Owner
Phone
(207) 590-6312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

10 W Bates St
Auburn, ME 04210-6270

Mailing address

99 Harvard St
Auburn, ME 04210-5232
Phone (207) 590-6312

Other identifiers 1

IdentifierTypeStateIssuer
1699922955MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL customfitphysicaltherapy@gmail.com

National Provider Directory

National Provider Directory

Locations

10 W Bates St
Auburn, ME 04210
Phone (207) 440-3171

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1659036382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HARVARD ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105232",
            "telephone_number": "207-590-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W BATES ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106270",
            "telephone_number": "207-590-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM FIT PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-590-6312",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699922955",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "customfitphysicaltherapy@gmail.com",
            "affiliation": "N",
            "address_1": "10 W Bates St",
            "city": "Auburn",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042106270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.