Personal Edge PT, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PERSONAL EDGE PT, INC.

Practice address

7080 Donlon Way Ste 108
Dublin, CA 94568-2788

Phone

(925) 556-4310

Fax

(925) 556-0375

NPI assigned

May 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Leeann Marie Price, DPTNPI 1063683738

Title

President/Clinical Director

Phone

(208) 230-5812

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

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

• Leeann Marie Price, PT

  • Physical Therapist
  • Dublin, CA
  • NPI 1063683738
  Medicare reassignment NPD Authorized official
• Lindsay Nicole Athan, PT, DPT

  • Physical Therapist
  • Dublin, CA
  • NPI 1063719664
  NPD
• Megan Fisher, PT, DPT

  • Physical Therapist
  • Dublin, CA
  • NPI 1033547112
  NPD (past)
• Ashleigh Miller, PT, DPT

  • Physical Therapist
  • Walnut Creek, CA
  • NPI 1760890941
  NPD (past)
• Katherine Kipouras, P.T.

  • Physical Therapist
  • Salem, NH
  • NPI 1578658324
  NPD (past)

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

{
    "created_epoch": "1588982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588982400000",
    "number": "1396367645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4964 ARNICA CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951113901",
            "telephone_number": "208-230-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DONLON WAY STE 108",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682788",
            "telephone_number": "925-556-4310",
            "fax_number": "925-556-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL EDGE PT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-09",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-230-5812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Perez
• Rebecca Reyna Perez
• Trier Perry
• Persimmon Dental Care
• Personal Edge Physical Therapy, Inc.
• Katherine Nicole Pesochinskiy
• Rebecca Pessagno
• Geera Peters, MD
• Rebekah Peterson
• Steven Mark Peterson, LCSW #23821

• Physical Therapy Clinic/Center in Dublin, CA
• Providers in Dublin, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2020; 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.