Fresh Life LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FRESH LIFE LLC

Doing business as

Pierre Physical Therapy & Rehabilitation

Practice address

633 E Sioux Ave Ste 5
Pierre, SD 57501-3368

Phone

(605) 222-8724

NPI assigned

Jul 13, 2020

Last updated

Jul 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Rounds, PT,DPTNPI 1609230309

Title

Owner

Phone

(605) 222-8724

Specialties & licenses 1

Addresses

Other names 1

• Pierre Physical Therapy & Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 5

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.

• John Michael Rounds, DPT

  • Physical Therapist
  • Pierre, SD
  • NPI 1609230309
  Medicare reassignment Care Compare group NPD Authorized official
• Chesney Hofer, PT, DPT, ATC

  • Physical Therapist
  • Pierre, SD
  • NPI 1760057384
  Medicare reassignment Care Compare group NPD
• Tori Rae King, DPT

  • Physical Therapist
  • Pierre, SD
  • NPI 1447009865
  Medicare reassignment Care Compare group NPD
• Brett Turner

  • Physical Therapist
  • Pierre, SD
  • NPI 1891462941
  Medicare reassignment Care Compare group NPD
• Tya Alexander, PTA

  • Physical Therapy Assistant
  • Pierre, SD
  • NPI 1205570439
  NPD

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1679191092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 E SIOUX AVE STE 5",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013368",
            "telephone_number": "605-222-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E SIOUX AVE STE 5",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013368",
            "telephone_number": "605-222-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "ROUNDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-222-8724",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pierre Physical Therapy & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whitney Elizabeth Flottmeyer, PHARM D.
• Fort Meade Vamc
• Allison Marie Fosheim, LPC, LPC-MH
• David Fossum, PAC
• Jessica Foth, LCSW-PIP, LAC, QMHP
• Patti Fuchs, RDH
• Shawna K Fullerton, MSW, LCSW
• Justin Michael Gabbert, PA-C
• Christie Ann Gabel, RPH
• Holly Beth Garrett, MS

• Physical Therapist in Pierre, SD
• Providers in Pierre, SD by specialty
• Physical Therapist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.