Custom Fitness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT-106 Issued in GU

Legal business name

CUSTOM FITNESS LLC

Doing business as

CrossFit Gof Metgot

Practice address

202 W Marine Corps Dr
Asan, GU 96910-5069

Phone

(671) 646-2379

NPI assigned

May 13, 2014

Last updated

Sep 23, 2026By 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

Samantha Sablan

Title

President

Phone

(671) 989-0436

Specialties & licenses 1

Addresses

Other names 1

• CrossFit Gof Metgot Doing business as

Medicare fee-for-service enrollment

Enrolled in GU

Enrollment records 1

Locations

Practitioners 4

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.

• Tasi Ann Guerrero Ada, PT, DPT, CSCS

  • Physical Therapy Clinic/Center
  • Hagatna, GU
  • NPI 1861169815
  Medicare reassignment NPD
• Gabrielle Kimura Lagutang, PT, DPT

  • Physical Therapist
  • Hagatna, GU
  • NPI 1801652896
  Medicare reassignment NPD
• Shaine Francis Tydingco Munoz, PT, DPT

  • Physical Therapist
  • Hagatna, GU
  • NPI 1225959539
  NPD (past)
• Eric Satoshi Redona, PT, DPT

  • Physical Therapist
  • Tamuning, GU
  • NPI 1700730553
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1902217896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W MARINE CORPS DR",
            "city": "ASAN",
            "state": "GU",
            "postal_code": "969105069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W MARINE CORPS DR",
            "city": "ASAN",
            "state": "GU",
            "postal_code": "969105069",
            "telephone_number": "671-646-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "SABLAN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "671-989-0436"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GU",
            "license": "PT-106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CrossFit Gof Metgot",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keokia Leora Mendiola, M.A., CCC-SLP

• Physical Therapy Clinic/Center in Asan, GU
• Providers in Asan, GU by specialty
• Physical Therapy Clinic/Center in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; 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.