Organization Active NPI

Maverick Performance and Physical Therapy

  • Physical Therapist
  • Panama City Beach, FL
National Provider Identifier
1104770171
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAVERICK PERFORMANCE AND PHYSICAL THERAPY
Practice address
24206 Panama City Beach Pkwy # 506
Panama City Beach, FL 32413-7313
Phone
(361) 688-8929
NPI assigned
Feb 25, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Authorized official

Name
Dr. Colby Courville, PT, DPTNPI 1326515479
Title
Owner
Phone
(361) 688-8929

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

24206 Panama City Beach Pkwy # 506
Panama City Beach, FL 32413-7313

Mailing address

24206 Panama City Beach Pkwy # 506
Panama City Beach, FL 32413-7313
Phone (361) 688-8929

National Provider Directory

National Provider Directory
Tax ID family
Maverick Performance and Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1771977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1104770171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24206 PANAMA CITY BEACH PKWY # 506",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324137313",
            "telephone_number": "361-688-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24206 PANAMA CITY BEACH PKWY # 506",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324137313",
            "telephone_number": "361-688-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK PERFORMANCE AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "COURVILLE",
        "authorized_official_first_name": "COLBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-688-8929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.