Life Fitness Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

03638F Issued in LA

Legal business name

LIFE FITNESS THERAPY LLC

Practice address

5438 Odonovan Dr
Suite 100
Baton Rouge, LA 70808-4364

Phone

(225) 769-0818

Fax

(225) 769-0819

NPI assigned

Aug 6, 2008

Last updated

Aug 20, 2013By 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

Mrs. Medy Manuel, PT

Title

Director

Phone

(225) 769-0818

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 3

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.

• Stephen Evangello Martin Manuel, P.T.

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1699794768
  Medicare reassignment Care Compare group NPD
• Medy Lim Manalo-Manuel, P.T.

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1134144892
  Medicare reassignment Care Compare group
• Amanda C. Perron, LDN, RD

  • Registered Dietitian
  • Baton Rouge, LA
  • NPI 1104192657
  NPD (past)

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1821254079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5438 ODONOVAN DR",
            "address_2": "SUITE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084364",
            "telephone_number": "225-769-0818",
            "fax_number": "225-769-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5438 ODONOVAN DR",
            "address_2": "SUITE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084364",
            "telephone_number": "225-769-0818",
            "fax_number": "225-769-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FITNESS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "MEDY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "225-769-0818",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "03638F",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "LA",
            "license": "PT01345F",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Life Enhancement Services of Louisiana Inc
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• Life Source Services, LLC (Life Source Services Baton Rouge)
• Lifeline Medical Transportation LLC
• Light House Community Care

• Physical Therapy Clinic/Center in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physical Therapy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.