Fundamental Therapy Inc

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

FUNDAMENTAL THERAPY INC

Practice address

4106 N 48TH Ave
Hollywood, FL 33021-1735

Phone

(954) 648-7819

NPI assigned

Oct 21, 2020

Organization subpart

No

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

Authorized official

Name

Anniel Nagler, MSPTNPI 1942445325

Title

Owner

Phone

(954) 648-7819

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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.

• Anniel R Nagler, PT

  • Pediatric Physical Therapist
  • Hollywood, FL
  • NPI 1942445325

  Pediatrics

  NPD Authorized official
• Daniel L Nagler, DMD

  • Periodontics
  • Boca Raton, FL
  • NPI 1912069113
  NPD (past)

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1922607845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 N 48TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211735",
            "telephone_number": "954-648-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 N 48TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211735",
            "telephone_number": "954-648-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "NAGLER",
        "authorized_official_first_name": "ANNIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-648-7819",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000288300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT20744",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pediatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.