NPIMap

Organization Active NPI

Performance Medicine LLC

  • Health Service Clinic/Center
  • Lexington, KY
National Provider Identifier
1508378738
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PERFORMANCE MEDICINE LLC
Practice address
110 W Vine St
Lexington, KY 40507-1658
Phone
(859) 208-6781
Fax
(859) 208-6803
NPI assigned
Oct 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Dr. Kanisha Hall, MDNPI 1861669186
Title
Owner
Phone
(202) 709-9822

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
Health Service Clinic/Center 261QH0100X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

110 W Vine St
Lexington, KY 40507-1658

Mailing address

3050 Post Oak Blvd Ste 510
Houston, TX 77056-6512
Phone (866) 943-2384

Other practice location 1

3050 Post Oak Blvd Ste 510
Houston, TX 77056-6512
Phone (866) 943-2384

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1508378738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 POST OAK BLVD STE 510",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770566512",
            "telephone_number": "866-943-2384",
            "fax_number": "713-885-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W VINE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071658",
            "telephone_number": "859-208-6781",
            "fax_number": "859-208-6803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3050 Post Oak Blvd Ste 510",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770566512",
            "country_code": "US",
            "telephone_number": "866-943-2384",
            "fax_number": "713-885-9572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERFORMANCE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KANISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-709-9822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.