Fitness Pantheon, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

008560 Issued in CT

Legal business name

FITNESS PANTHEON, LLC

Practice address

221 Water Street
Torrington, CT 06790

Phone

(860) 967-9341

NPI assigned

Mar 4, 2014

Organization subpart

No

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

Authorized official

Name

James O'Brien, PT

Title

Co-Owner, Physical Therapist

Phone

(860) 967-9341

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1992120646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WATER STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WATER STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-967-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS PANTHEON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CO-OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "860-967-9341",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "008560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004190328",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "076503001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Leo Finn, D.D.S.
• Amy Fiorello, LCSW
• Catherine R Fiorello, LMFT
• Daniel Fisher, PT
• Matthew Fisher, LCSW
• Aaron William Floch, MD
• Foothills Family Care LLC
• Richard Robert Forest, MD
• Annika Foster, LMSW
• Elizabeth Norton Foster, APRN

• Physical Therapy Clinic/Center in Torrington, CT
• Providers in Torrington, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.