NPIMap

Organization Active NPI

Build Physio & Performance, PLLC

  • Physical Therapist
  • Bozeman, MT
National Provider Identifier
1568946291
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BUILD PHYSIO & PERFORMANCE, PLLC
Practice address
609 Pronghorn Trail
Bozeman, MT 59718
Phone
(406) 580-0803
Fax
(406) 258-0580
NPI assigned
Sep 19, 2018
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Laura Opstedal, PT, DPTNPI 1194890780
Title
Owner/Physical Therapist
Phone
(406) 580-0803

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Sports Physical Therapist 2251S0007X
Orthopedic Physical Therapist 2251X0800X

Addresses

Primary practice location

609 Pronghorn Trail
Bozeman, MT 59718

Mailing address

609 Pronghorn TRL Ste C
Bozeman, MT 59718-7090
Phone (406) 580-0803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181221002535 MT Part B Supplier - Clinic/Group Practice 3274878020 Receives reassigned benefits from 5 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

609 Pronghorn Trl
Bozeman, MT 59718
Phone (406) 580-0803

609 Pronghorn Trl
Ste C
Bozeman, MT 59718
Phone (406) 580-0803

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1568946291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 PRONGHORN TRL STE C",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187090",
            "telephone_number": "406-580-0803",
            "fax_number": "406-258-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 PRONGHORN TRAIL",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-580-0803",
            "fax_number": "406-258-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUILD PHYSIO & PERFORMANCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "OPSTEDAL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "406-580-0803",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.