Functional Fitness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FUNCTIONAL FITNESS LLC

Doing business as

Anytime Fitness

Practice address

4790 Caughlin Pkwy # 525
Reno, NV 89519-0907

Phone

(775) 622-8034

NPI assigned

Jun 15, 2017

Organization subpart

No

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

Authorized official

Name

Suzanne Lucas, NASM, IDEA, CPT

Title

Owner / Manager

Phone

(775) 622-8034

Specialties & licenses 1

Addresses

Other names 1

• Anytime Fitness Doing business as

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912437583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 CAUGHLIN PKWY # 525",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895190907",
            "telephone_number": "775-622-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 CAUGHLIN PKWY # 525",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895190907",
            "telephone_number": "775-622-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER / MANAGER",
        "authorized_official_telephone_number": "775-622-8034",
        "authorized_official_credential": "NASM, IDEA, CPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anytime Fitness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anytime Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gloria Fuller
• Maxwell Richard Fuller
• Spencer Fuller, MD, MPH
• Brendan Rice Fulmer, MD
• Dara Fulstone
• Functional Medicine of Nevada PLLC
• Stephanie Funderburk
• Tatum Funderburk
• Adele D. Fung, MD
• Brian Y Fung, M.D.

• Physical Therapy Clinic/Center in Reno, NV
• Providers in Reno, NV by specialty
• Physical Therapy Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.