Engage Movement Physio and Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2977 Issued in NV

Legal business name

ENGAGE MOVEMENT PHYSIO AND PERFORMANCE LLC

Practice address

961 Matley LN
#170
Reno, NV 89502-2188

Phone

(702) 480-0568

NPI assigned

Mar 8, 2017

Last updated

Mar 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond Gorman, DPT

Title

Owner/Physical Therapist

Phone

(702) 480-0568

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1114467222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10522 EAGLE FALLS WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214153",
            "telephone_number": "702-480-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MATLEY LN",
            "address_2": "#170",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022188",
            "telephone_number": "702-480-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGAGE MOVEMENT PHYSIO AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "702-480-0568",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NV",
            "license": "2977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.