Broome Orthopedic & Sport Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

017381-1 Issued in NY

Legal business name

BROOME ORTHOPEDIC & SPORT PHYSICAL THERAPY

Practice address

800 Valley PLZ
Suite 9
Johnson City, NY 13790-1046

Phone

(607) 729-2200

Fax

(607) 729-2202

NPI assigned

May 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Todd Peake, PTNPI 1598723744

Title

Owner/Physical Therapist

Phone

(607) 729-2200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

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

• Gregory Todd Peake, PT

  • Physical Therapist
  • Johnson City, NY
  • NPI 1598723744
  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas Chernega, PHYSICAL THERAPIST

  • Physical Therapist
  • Johnson City, NY
  • NPI 1730589227
  Medicare reassignment Care Compare group NPD
• Timothy Ehret, D.P.T.

  • Physical Therapist
  • Johnson City, NY
  • NPI 1720313547
  Medicare reassignment NPD
• Christopher Charles Wade, PT

  • Physical Therapist
  • Clark Summit, PA
  • NPI 1518925874
  NPD (past)

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487605572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 VALLEY PLZ",
            "address_2": "SUITE 9",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901046",
            "telephone_number": "607-729-2200",
            "fax_number": "607-729-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VALLEY PLZ",
            "address_2": "SUITE 9",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901046",
            "telephone_number": "607-729-2200",
            "fax_number": "607-729-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOME ORTHOPEDIC & SPORT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEAKE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "607-729-2200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "017381-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory J Bretz, PA
• Diana L Brewer, MS, CCC-SLP
• Aaron Bridgemohan
• Tyson Don Brierley, D.O.
• Broome Oncology LLC
• Broome Surgery & Breast Care, P.C.
• John Brosnan, MD
• Calvin William Brown, LCSW-R
• Molly Brown, DPT
• Stefani M Brown, MS, CCC-SLP

• Physical Therapy Clinic/Center in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.