Peak Physical Therapy and Performance Training LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PEAK PHYSICAL THERAPY AND PERFORMANCE TRAINING LLC

Practice address

4050 Candle Light Dr
Dayton, MD 21036-1141

Phone

(201) 873-8406

NPI assigned

Mar 1, 2022

Last updated

Mar 1, 2022By 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

Dr. Kristan Leigh Fish, DPTNPI 1720693005

Title

Owner

Phone

(201) 873-8406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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.

• Kristan Leigh Fish, DPT

  • Physical Therapist
  • Dayton, MD
  • NPI 1720693005
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1306592209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 CANDLE LIGHT DR",
            "city": "DAYTON",
            "state": "MD",
            "postal_code": "210361141",
            "telephone_number": "201-873-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 CANDLE LIGHT DR",
            "city": "DAYTON",
            "state": "MD",
            "postal_code": "210361141",
            "telephone_number": "201-873-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PHYSICAL THERAPY AND PERFORMANCE TRAINING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "KRISTAN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-873-8406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Iammatteo, M.S., O.T.R./L.
• Patricia Keeney Keating, PT
• Elizabeth Knowlden, CNS, LDN
• Gail Rene Mielke, M.A. CCC-SLP
• Nature's Nourished Kitchen LLC
• Rileigh Smith, CNS, LDN
• Mahtab Vasigh
• Sarah Wainwright, MS, CCC-SLP
• David Nathan Zahm, PH.D.

• Physical Therapy Clinic/Center in Dayton, MD
• Providers in Dayton, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.