Genesis Fitness, LLC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

GENESIS FITNESS, LLC

Practice address

2701 Ross Clark Cir
Dothan, AL 36301-3203

Phone

(334) 699-5099

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Lavandia Harris

Title

Owner

Phone

(334) 699-5099

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1801288188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013203",
            "telephone_number": "334-699-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LAVANDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-699-5099",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Dothan, AL
• Providers in Dothan, AL by specialty
• Athletic Trainer in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.