Facilitated Fitness LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FACILITATED FITNESS LLC

Practice address

106 Willocks Rd
Johnson City, TN 37601-6274

Phone

(423) 218-9703

NPI assigned

Apr 23, 2024

Organization subpart

No

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

Authorized official

Name

Matthew William Clemson, DPTNPI 1407151004

Title

Owner/ Physical Therapist

Phone

(423) 218-9703

Specialties & licenses 1

Addresses

Practitioners 1

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

• Matthew W Clemson, P.T.

  • Physical Therapist
  • Farragut, TN
  • NPI 1407151004
  NPD Authorized official

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1891540613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WILLOCKS RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376016274",
            "telephone_number": "423-218-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WILLOCKS RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376016274",
            "telephone_number": "423-218-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACILITATED FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "CLEMSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/ PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "423-218-9703",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey D Fabozzi, DC
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• Tabitha Nicole Fair, RDH
• Fairview Housing & Management Corporation

• Physical Therapist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.