NPIMap

Organization Active NPI

Performance Physical Therapy, Inc. P.S.

  • Physical Therapist
  • Bellingham, WA
National Provider Identifier
1124402292
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PERFORMANCE PHYSICAL THERAPY, INC. P.S.
Practice address
420 Ohio St
Bellingham, WA 98225-4637
Phone
(360) 714-0870
Fax
(360) 714-0872
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Mr. Brian Joseph Weeda, MSPTATNPI 1972650083
Title
Owner
Phone
(360) 303-8420

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X PT00006136 WA

Addresses

Primary practice location

420 Ohio St
Bellingham, WA 98225-4637

Mailing address

420 Ohio St
Bellingham, WA 98225-4637
Phone (360) 714-0870

Other names 1

  • Whatcom Sports Institute Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151216001849 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597066589 Receives reassigned benefits from 7 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

4600 Guide Meridian
Ste 108
Bellingham, WA 98226
Phone (360) 312-4768

1204 Railroad Ave
Ste 101
Bellingham, WA 98225
Phone (360) 714-0870

420 Ohio St
Bellingham, WA 98225
Phone (360) 714-0870

Practitioners & affiliated clinicians

Practitioners 8

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": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1124402292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 OHIO ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254637",
            "telephone_number": "360-714-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 OHIO ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254637",
            "telephone_number": "360-714-0870",
            "fax_number": "360-714-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY, INC. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "WEEDA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-303-8420",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPTAT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00006136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whatcom Sports Institute",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.