NPIMap

Organization Active NPI

Mobility Fit Physical Therapy, LLC

  • Physical Therapist
  • Dayton, OH
National Provider Identifier
1760089015
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOBILITY FIT PHYSICAL THERAPY, LLC
Practice address
4242 Clyo Rd
Dayton, OH 45440-6101
Phone
(513) 802-1929
Fax
(888) 972-7349
NPI assigned
Oct 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Andrew Samuel CookNPI 1033548763
Title
Owner
Phone
(303) 710-0515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4242 Clyo Rd
Dayton, OH 45440-6101

Mailing address

7753 Cox LN # 31
West Chester, OH 45069-6549
Phone (513) 802-1929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180112001546 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052670379 Receives reassigned benefits from 19 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beavercreek, OH; Blue Ash, OH; Centerville, OH; Lebanon, OH; West Chester, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4242 Clyo Rd
Dayton, OH 45440
Phone (513) 802-1929

801 W Main St
Lebanon, OH 45036
Phone (513) 491-0888

715 Congress Park Dr
Washington Township, OH 45459
Phone (513) 802-1929

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1760089015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7753 COX LN # 31",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696549",
            "telephone_number": "513-802-1929",
            "fax_number": "888-972-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 CLYO RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454406101",
            "telephone_number": "513-802-1929",
            "fax_number": "888-972-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY FIT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-710-0515"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.