NPIMap

Organization Active NPI

Performance PT LLC

  • Orthopedic Physical Therapist
  • Wayne, NJ
National Provider Identifier
1003196213
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
PERFORMANCE PT LLC
Practice address
15 Corporate Dr Ste 6
Wayne, NJ 07470-3120
Phone
(973) 368-4907
Fax
(973) 368-4909
NPI assigned
Aug 18, 2011
Last updated
Aug 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Brad Samples, DPTNPI 1679605752
Title
Owner
Phone
(973) 368-4907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X NU Primary

Addresses

Primary practice location

15 Corporate Dr Ste 6
Wayne, NJ 07470-3120

Mailing address

15 Corporate Dr Ste 6
Wayne, NJ 07470-3120
Phone (973) 368-4907

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1003196213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CORPORATE DR STE 6",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703120",
            "telephone_number": "973-368-4907",
            "fax_number": "973-368-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORPORATE DR STE 6",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703120",
            "telephone_number": "973-368-4907",
            "fax_number": "973-368-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "SAMPLES",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-368-4907",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.