Organization Active NPI

Performance Physical Therapy, LLC

  • Physical Therapist
  • Lansing, MI
National Provider Identifier
1043249113
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006693 Issued in MI
Legal business name
PERFORMANCE PHYSICAL THERAPY, LLC
Practice address
6540 Millennium
Suite 110
Lansing, MI 48917-7848
Phone
(517) 420-0385
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Authorized official

Name
Mr. Shazer A Emata, RPT
Title
PT
Phone
(517) 420-0385

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5501006693 MI Primary

Addresses

Primary practice location

6540 Millennium
Suite 110
Lansing, MI 48917-7848

Mailing address

6540 Millennium
Suite 110
Lansing, MI 48917-7848
Phone (517) 420-0385

National Provider Directory

National Provider Directory

Locations

6540 Millennium
Ste 110
Lansing, MI 48917
Phone (517) 420-0385

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1043249113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 MILLENNIUM",
            "address_2": "SUITE 110",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177848",
            "telephone_number": "517-420-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 MILLENNIUM",
            "address_2": "SUITE 110",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177848",
            "telephone_number": "517-420-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "EMATA",
        "authorized_official_first_name": "SHAZER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "517-420-0385",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.