Organization Active NPI

Peak Performance Physical Therapy

  • Physical Therapist
  • Lewiston, ID
National Provider Identifier
1205157252
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEAK PERFORMANCE PHYSICAL THERAPY
Practice address
216 Larkspur LN
Lewiston, ID 83501-9600
Phone
(208) 746-0455
Fax
(208) 746-0688
NPI assigned
Jun 14, 2010
Last updated
Sep 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Authorized official

Name
David Dale Biery, MBA
Title
Co-Owner
Phone
(208) 305-3539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

216 Larkspur LN
Lewiston, ID 83501-9600

Mailing address

216 Larkspur LN
Lewiston, ID 83501-9600
Phone (208) 746-0455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100902000450 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082738604 Receives reassigned benefits from 3 practitioners
Practice locations: Lewiston, ID

National Provider Directory

National Provider Directory

Locations

1010 Bryden Ave
Unit A
Lewiston, ID 83501
Phone (208) 746-0455

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1205157252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 LARKSPUR LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835019600",
            "telephone_number": "208-746-0455",
            "fax_number": "208-746-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 LARKSPUR LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835019600",
            "telephone_number": "208-746-0455",
            "fax_number": "208-746-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "BIERY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "208-305-3539",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.