NPIMap

Organization Active NPI

Performax Physical Therapy and Sports Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Durham, NC
National Provider Identifier
1376093906
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
11174 Issued in NC
Legal business name
PERFORMAX PHYSICAL THERAPY AND SPORTS REHABILITATION, LLC
Practice address
5501 Fortunes Ridge Dr
Ste. L
Durham, NC 27713-6102
Phone
(919) 710-2681
NPI assigned
Oct 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Bryan LittlejohnNPI 1003062696
Title
Owner
Phone
(919) 710-2681

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 11174 NC Primary

Addresses

Primary practice location

5501 Fortunes Ridge Dr
Ste. L
Durham, NC 27713-6102

Mailing address

5501 Fortunes Ridge Dr
Ste. L
Durham, NC 27713-6102

National Provider Directory

National Provider Directory
Tax ID family
Performax Physical Therapy and Sports Re2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5501 Fortunes Ridge Dr
Ste L
Durham, NC 27713
Phone (919) 710-2681

Practitioners & affiliated clinicians

Practitioners 2

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": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1376093906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR",
            "address_2": "STE. L",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR",
            "address_2": "STE. L",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-710-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMAX PHYSICAL THERAPY AND SPORTS REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "LITTLEJOHN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-710-2681",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": "11174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.