Peak Performance Physical Therapy and Sports Medicine, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20793500 Issued in ND

Legal business name

PEAK PERFORMANCE PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC

Practice address

207 1St Ave S
Suite C
New Rockford, ND 58356-1800

Phone

(701) 947-2030

NPI assigned

Oct 11, 2006

Organization subpart

No

Name

Mrs. Jodi Ann Tjelta, PT/ATC

Title

President/Owner

Phone

(701) 947-2030

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Allen Ystaas, PT, DPT

  • Physical Therapist
  • Bismarck, ND
  • NPI 1750675856

  ND, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Melissa Ystaas, PT

  • Physical Therapist
  • New Rockford, ND
  • NPI 1164821153

  ND, Physical Therapist

  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 26, 2011.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1336237403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 1ST AVE S STE C",
            "city": "NEW ROCKFORD",
            "state": "ND",
            "postal_code": "583561800",
            "telephone_number": "701-947-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1ST AVE S",
            "address_2": "SUITE C",
            "city": "NEW ROCKFORD",
            "state": "ND",
            "postal_code": "583561800",
            "telephone_number": "701-947-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "TJELTA",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "701-947-2030",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT/ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "20793500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55080",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Clark Masdea Jr.
• Michelle Moen
• Nicolai Chiropractic Center, P.C.
• Michael Kenneth Nicolai, DC
• Dusti L Nystrom
• Michelle Pfeiffer, LMT
• Zachary Tomas Smith, D.C.
• Georgianna Walker, MS, LRD
• Kimberly Weber, DC, MS
• Bonnie Williams, LSW

• All providers in New Rockford, ND
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.