NPIMap

Organization Active NPI

Peak Performance Therapy LLC

  • Occupational Therapist
  • Sequim, WA
National Provider Identifier
1063796175
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00003652 Issued in WA
Legal business name
PEAK PERFORMANCE THERAPY LLC
Practice address
519 Eureka Way, Suite 2
Sequim, WA 98382
Phone
(360) 683-8331
Fax
(360) 683-8441
NPI assigned
Oct 7, 2011
Last updated
Jan 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Mr. James Aaron Staeben, OT, CHTNPI 1639123110
Title
Owner
Phone
(360) 683-8331

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
Occupational Therapist 225X00000X OT 00003652 WA Primary

Addresses

Primary practice location

519 Eureka Way, Suite 2
Sequim, WA 98382

Mailing address

519 Eureka Way, Suite 2
Sequim, WA 98382
Phone (360) 683-8331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111110000179 WA Part B Supplier - Clinic/Group Practice 6709050693 Receives reassigned benefits from 5 practitioners
Practice locations: Sequim, WA
O20111230000307 WA DME Supplier - Independently-Practicing Occupational Therapist 6709050693 Practice locations: Sequim, WA

National Provider Directory

National Provider Directory

Locations

519 Eureka Way
Ste 2
Sequim, WA 98382
Phone (360) 683-8331

578 N 5th Ave
Sequim, WA 98382
Phone (360) 683-8331

Practitioners & affiliated clinicians

Practitioners 5

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": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1063796175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 EUREKA WAY, SUITE 2",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "98382",
            "telephone_number": "360-683-8331",
            "fax_number": "360-683-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 EUREKA WAY, SUITE 2",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "98382",
            "telephone_number": "360-683-8331",
            "fax_number": "360-683-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "STAEBEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-683-8331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OT, CHT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00003652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.