NPIMap

Organization Active NPI

Peronia Physical Therapy

  • Physical Therapist
  • Pea Ridge, AR
National Provider Identifier
1649633793
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 672 Issued in AR
Legal business name
PERONIA PHYSICAL THERAPY
Practice address
823 Slack St
Pea Ridge, AR 72751-3703
Phone
(479) 451-9434
Fax
(479) 488-6220
NPI assigned
Apr 5, 2016
Last updated
Apr 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Mitzi Peronia, PT
Title
PT / Owner
Phone
(479) 451-9434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 672 AR Primary

Addresses

Primary practice location

823 Slack St
Pea Ridge, AR 72751-3703

Mailing address

PO Box 411
Pea Ridge, AR 72751-0411
Phone (479) 451-9434

National Provider Directory

National Provider Directory

Locations

823 Slack St
Pea Ridge, AR 72751
Phone (479) 451-9434

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": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1649633793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727510411",
            "telephone_number": "479-451-9434",
            "fax_number": "479-488-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 SLACK ST",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727513703",
            "telephone_number": "479-451-9434",
            "fax_number": "479-488-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERONIA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "PERONIA",
        "authorized_official_first_name": "MITZI",
        "authorized_official_title_or_position": "PT / OWNER",
        "authorized_official_telephone_number": "479-451-9434",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pea Ridge, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.