Vital Performance Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

VITAL PERFORMANCE PHYSICAL THERAPY LLC

Practice address

9 Mary Way
Hainesport, NJ 08036-2729

Phone

(609) 676-5905

NPI assigned

Oct 25, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Michael Shaddow, DPTNPI 1881357861

Title

Owner

Phone

(609) 864-1709

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michael Shaddow, PT, DPT, CERT. MDT

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1881357861
  NPD Authorized official

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1629795273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 RANCOCAS RD",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080601320",
            "telephone_number": "609-864-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MARY WAY",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362729",
            "telephone_number": "609-676-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PERFORMANCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "SHADDOW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-864-1709",
        "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": []
}

• Union Association of the Children'S Home of Burlington County, Inc.
• Union Association of the Children'S Home of Burlington County, Inc.
• Myra Theresa Vargas, M.D.
• Lara Elizabeth Viggiano, MPT
• Visiting Nurse & Homemakers Services Inc
• Grace Wall, PT, DPT
• Diann Wallace, D.C.
• Rebecca Knight Warren
• Rodney Keith Williams Jr.
• Mary Winkelspecht, LSW

• Physical Therapy Clinic/Center in Hainesport, NJ
• Providers in Hainesport, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.