NPIMap

Organization Active NPI

Performance Physiotherapy, Inc.

  • Physical Therapist
  • Princess Anne, MD
National Provider Identifier
1295131464
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P11098 Issued in NC
Legal business name
PERFORMANCE PHYSIOTHERAPY, INC.
Practice address
12137 Elm St
Princess Anne, MD 21853-1358
Phone
(252) 367-1118
NPI assigned
Nov 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
Derrick Briddell, PTNPI 1740287259
Title
President
Phone
(252) 367-1118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X P11098 NC Primary

Addresses

Primary practice location

12137 Elm St
Princess Anne, MD 21853-1358

Mailing address

PO Box 54
Zebulon, NC 27597-0054
Phone (919) 404-1448

National Provider Directory

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, 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": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1295131464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275970054",
            "telephone_number": "919-404-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12137 ELM ST",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531358",
            "telephone_number": "252-367-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSIOTHERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "BRIDDELL",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-367-1118",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P11098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.