NPIMap

Organization Active NPI

Senior Fit Physical Therapy LLC

  • Physical Therapist
  • West Grove, PA
National Provider Identifier
1881290716
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SENIOR FIT PHYSICAL THERAPY LLC
Practice address
206 N Jennersville Rd Ste 100
West Grove, PA 19390-9326
Phone
(610) 869-6833
NPI assigned
Dec 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Tim Mudgett- McGeoch, PTNPI 1447238423
Title
Owner
Phone
(484) 667-8295

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

206 N Jennersville Rd Ste 100
West Grove, PA 19390-9326

Mailing address

23 Dutton Farm LN
West Grove, PA 19390-9473
Phone (484) 667-8295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210105002695 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022421312 Receives reassigned benefits from 4 practitioners
Practice locations: West Grove, PA

National Provider Directory

National Provider Directory

Locations

206 N Jennersville Rd
Ste 100
West Grove, PA 19390
Phone (484) 667-8295

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1881290716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 DUTTON FARM LN",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909473",
            "telephone_number": "484-667-8295",
            "fax_number": "484-727-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N JENNERSVILLE RD STE 100",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909326",
            "telephone_number": "610-869-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR FIT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "MUDGETT- MCGEOCH",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-667-8295",
        "authorized_official_credential": "PT"
    },
    "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 West Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.