Personal Performance Medical Corporation

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PERSONAL PERFORMANCE MEDICAL CORPORATION

Practice address

720 S River Rd Ste B205
St George, UT 84790-5532

Phone

(435) 634-0070

Fax

(435) 634-0070

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Scott E Allen, CERTIFIED PROSTHETIS

Title

Owner

Phone

(801) 364-3100

Specialties & licenses 1

Addresses

Other names 1

• Fit-Well Prosthetic and Orthotic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Personal Performance Medical Corporation

  • Prosthetic/Orthotic Supplier
  • Ogden, UT
  • NPI 1114154622

  1355468059

  Same PAC ID
• Personal Performance Medical Corporation

  • Prosthetic/Orthotic Supplier
  • Midvale, UT
  • NPI 1528041662

  1355468059

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Fit-Well Pros Orth CN3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Personal Performance Medical Corporation

  • Prosthetic/Orthotic Supplier
  • Ogden, UT
  • NPI 1114154622
  NPD tax ID
• Personal Performance Medical Corporation

  • Prosthetic/Orthotic Supplier
  • Midvale, UT
  • NPI 1528041662
  NPD tax ID

Locations

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1083841597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 S 900 E",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472343",
            "telephone_number": "801-364-3100",
            "fax_number": "801-872-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S RIVER RD STE B205",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905532",
            "telephone_number": "435-634-0070",
            "fax_number": "435-634-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL PERFORMANCE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-364-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED PROSTHETIS"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fit-Well Prosthetic and Orthotic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in St George, UT
• Providers in St George, UT by specialty
• Prosthetic/Orthotic Supplier in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.