NPIMap

Organization Active NPI

Fitness Quest-Port Charlotte LLC

  • Physical Therapy Clinic/Center
  • Port Charlotte, FL
National Provider Identifier
1679761696
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FITNESS QUEST-PORT CHARLOTTE LLC
Practice address
1649 Tamiami TRL Ste 1a
Port Charlotte, FL 33948-1019
Phone
(941) 743-6700
Fax
(941) 743-6707
NPI assigned
Oct 4, 2007
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Mrs. Mackenzie M Bartruff
Title
Coo
Phone
(941) 743-6700

Specialties & licenses 1

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

Addresses

Primary practice location

1649 Tamiami TRL Ste 1a
Port Charlotte, FL 33948-1019

Mailing address

3657 Cortez Rd W Ste 110
Bradenton, FL 34210-3171
Phone (941) 743-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080314000451 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2264517234 Receives reassigned benefits from 15 practitioners
Practice locations: Port Charlotte, FL

National Provider Directory

National Provider Directory

Locations

2886 Tamiami Trl
Ste 4
Port Charlotte, FL 33952
Phone (941) 743-6700

1649 Tamiami Trl
Ste 1A
Pt Charlotte, FL 33948
Phone (941) 743-6700

4161 Tamiami Trl
Ste 103
Pt Charlotte, FL 33952
Phone (941) 743-6700

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1679761696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3657 CORTEZ RD W STE 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103171",
            "telephone_number": "941-743-6700",
            "fax_number": "941-743-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 TAMIAMI TRL STE 1A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481019",
            "telephone_number": "941-743-6700",
            "fax_number": "941-743-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS QUEST-PORT CHARLOTTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "BARTRUFF",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "941-743-6700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.