Achieve Physical Therapy and Sports Performance, LLC

Key facts

NPI

1053646646

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

05009604A (IN)

Legal business name

ACHIEVE PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC

Practice address

202 E Harcourt Rd Ste U
Angola, IN 46703-7198

Phone

(260) 665-7000

Fax

(260) 665-6480

NPI assigned

Oct 15, 2009

Organization subpart

No

Authorized official

Name

Robin Weidinger

Title

Office Manager

Phone

(260) 665-7000

Practitioners 5

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

• Elizabeth Maria Anzelmo, P.T. Physical Therapist · Angola, IN · NPI 1104968486
  Medicare reassignment Care Compare group NPD IN · PHYSICAL THERAPIST
• Kirsten Ferrigan, PT, DPT Physical Therapist · Auburn, IN · NPI 1033590872
  Medicare reassignment Care Compare group NPD IN · PHYSICAL THERAPIST
• Emily A Watkins, PT Physical Therapist · Angola, IN · NPI 1417515131
  Medicare reassignment Care Compare group NPD IN · PHYSICAL THERAPIST
• Duane Gaerte, PTA Physical Therapy Assistant · Angola, IN · NPI 1811358815
  NPD (past)
• Cherie Mathews, PTA Physical Therapy Assistant · Angola, IN · NPI 1528429503
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 2, 2024.

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1053646646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467030628",
            "telephone_number": "260-665-7000",
            "fax_number": "260-665-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E HARCOURT RD STE U",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037198",
            "telephone_number": "260-665-7000",
            "fax_number": "260-665-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHIEVE PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "WEIDINGER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "260-665-7000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "05009604A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

• Rachel Susanne Adams, PTA
• Virginia M Adams, LMHC
• Jacqueline Leigh Akey, MD
• Andrew Aldred, PHARMD
• Rachel Allen, PHARMD

All providers in Angola, IN · Specialist in Indiana