The Forge - Health and Fitness Group LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THE FORGE - HEALTH AND FITNESS GROUP LLC

Practice address

955 Waimanu St
Honolulu, HI 96814-3319

Phone

(808) 818-3433

Fax

(808) 427-6071

NPI assigned

Nov 2, 2021

Organization subpart

No

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

Authorized official

Name

Justin Fukunaga, DPTNPI 1508235011

Title

Manager

Phone

(808) 551-8648

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Justin Fukunaga

  • Physical Therapist
  • Honolulu, HI
  • NPI 1508235011
  NPD Authorized official

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1841955242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 WARD AVE APT 904",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 WAIMANU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143319",
            "telephone_number": "808-818-3433",
            "fax_number": "808-427-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FORGE - HEALTH AND FITNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "FUKUNAGA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "808-551-8648",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Honolulu, HI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.