NPIMap

Organization Active NPI

Forever Fit Physical Therapy & Wellness, LLC

  • Hand Occupational Therapist
  • Burtonsville, MD
National Provider Identifier
1922419506
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
Legal business name
FOREVER FIT PHYSICAL THERAPY & WELLNESS, LLC
Practice address
3901 National Dr
Suite 100
Burtonsville, MD 20866-1141
Phone
(301) 421-1125
Fax
(301) 500-2175
NPI assigned
May 16, 2014
Last updated
May 12, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FOREVER FIT PHYSICAL THERAPY & WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Ryan C Frederic
Title
Member
Phone
(301) 421-1125

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Rehabilitation Clinic/Center 261QR0400X NU
Hand Occupational Therapist 225XH1200X NU Primary

Addresses

Primary practice location

3901 National Dr
Suite 100
Burtonsville, MD 20866-1141

Mailing address

PO Box 356
Burtonsville, MD 20866-0356
Phone (301) 421-1125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020000073 DC Part B Supplier - Clinic/Group Practice 1153513122 Receives reassigned benefits from 42 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silver Spring, MD; Rockville, MD; Gaithersburg, MD; Burtonsville, MD; Bowie, MD; Largo, MD

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Forever Fit Physical Therapy Wellness

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1922419506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208660356",
            "telephone_number": "301-421-1125",
            "fax_number": "301-500-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NATIONAL DR",
            "address_2": "SUITE 100",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661141",
            "telephone_number": "301-421-1125",
            "fax_number": "301-500-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER FIT PHYSICAL THERAPY & WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOREVER FIT PHYSICAL THERAPY & WELLNESS LLC",
        "enumeration_date": "2014-05-16",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "FREDERIC",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "301-421-1125"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.