Organization Active NPI

Trademark Performance Corporation

  • Physical Therapist
  • Dyer, IN
National Provider Identifier
1457800443
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TRADEMARK PERFORMANCE CORPORATION
Practice address
1427 Lincoln Hwy Unit C
Dyer, IN 46311-2026
Phone
(517) 425-2882
NPI assigned
Oct 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Michael HornbuckleNPI 1922093418
Title
President
Phone
(517) 425-2882

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X

Addresses

Primary practice location

1427 Lincoln Hwy Unit C
Dyer, IN 46311-2026

Mailing address

9145 W 103Rd St
Saint John, IN 46373-8794

Other practice location 1

4590 W 61st Ave
Hobart, IN 46342-6474
Phone (517) 425-2882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190408001698 IN Part B Supplier - Clinic/Group Practice 9436431319 Receives reassigned benefits from 2 practitioners
Practice locations: Dyer, IN

National Provider Directory

National Provider Directory

Locations

15800 State St
South Holland, IL 60473
Phone (517) 425-2881

1427 Lincoln Hwy
Ste C
Dyer, IN 46311
Phone (219) 319-0110

4590 W 61st Ave
Hobart, IN 46342
Phone (517) 425-2882

Practitioners & affiliated clinicians

Practitioners 3

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": "1475366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1457800443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9145 W 103RD ST",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 LINCOLN HWY UNIT C",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463112026",
            "telephone_number": "517-425-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4590 W 61st Ave",
            "address_purpose": "LOCATION",
            "city": "Hobart",
            "state": "IN",
            "postal_code": "463426474",
            "country_code": "US",
            "telephone_number": "517-425-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRADEMARK PERFORMANCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-02",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "HORNBUCKLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-425-2882"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.