Fit Athletic CMR LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FIT ATHLETIC CMR LLC

Practice address

12171 World Trade Dr
San Diego, CA 92128-3709

Phone

(858) 674-4480

NPI assigned

Apr 12, 2017

Organization subpart

No

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

Authorized official

Name

Chad Shaw

Title

General Manager

Phone

(858) 675-4480

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Michelle Denise Campillo-Peters, PTA

  • Physical Therapy Assistant
  • San Diego, CA
  • NPI 1144413881
  NPD (past)
• Karen Ellen Guerin, P.T.

  • Orthopedic Physical Therapist
  • San Diego, CA
  • NPI 1235161050
  NPD (past)
• Beth Ann Scalone, DPT, OCS

  • Physical Therapist
  • San Diego, CA
  • NPI 1568487296
  NPD (past)

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1952835472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 WORLD TRADE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283709",
            "telephone_number": "858-674-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12171 WORLD TRADE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283709",
            "telephone_number": "858-674-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIT ATHLETIC CMR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "858-675-4480"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fisiopro1
• Matthew Fisk
• Katelan Van Saun Fiske, M.S. CCC-SLP
• Mariah Jordan Fiske
• Fit Athletic Club San Diego LLC
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.
• Fit Athletic Physical Therapy, Inc.
• Desiree Alexis Fitch

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.