Organization Active NPI

Peak Performance Chiropractic LLC

  • Chiropractor
  • Maryville, IL
National Provider Identifier
1104319482
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PEAK PERFORMANCE CHIROPRACTIC LLC
Practice address
62 Executive Plaza CT
Maryville, IL 62062-5822
Phone
(618) 650-8062
NPI assigned
Jun 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Dr. Lindsey Langendorf, DC
Title
Owner
Phone
(618) 650-8062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

62 Executive Plaza CT
Maryville, IL 62062-5822

Mailing address

62 Executive Plaza CT
Maryville, IL 62062-5822
Phone (618) 650-8062

National Provider Directory

National Provider Directory

Locations

62 Executive Plaza Ct
Maryville, IL 62062
Phone (618) 288-1796

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": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1104319482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 EXECUTIVE PLAZA CT",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625822",
            "telephone_number": "618-650-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 EXECUTIVE PLAZA CT",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625822",
            "telephone_number": "618-650-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "LANGENDORF",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-650-8062",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.