Dynamic Performance Therapy and Rehabilitation, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

DYNAMIC PERFORMANCE THERAPY AND REHABILITATION, INC

Doing business as

Dynamic Performance Physical Therapy

Practice address

147 Castle Dr
Madison, AL 35758-8257

Phone

(256) 837-5425

Fax

(256) 837-2139

NPI assigned

Nov 1, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Samuel Peterson, D.P.T.NPI 1801973276

Title

Owner/Executive Director

Phone

(256) 837-5425

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dynamic Performance Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

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.

• David Samuel Peterson, D.P.T

  • Physical Therapist
  • Madison, AL
  • NPI 1801973276
  Medicare reassignment NPD Authorized official
• Edward Titus Goodman III, PT

  • Physical Therapist
  • Huntsville, AL
  • NPI 1801988910
  NPD (past)
• Alexia Danielle Harrigan, D.P.T.

  • Physical Therapist
  • Garland, TX
  • NPI 1740367010
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669559944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 CASTLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588257",
            "telephone_number": "256-837-5425",
            "fax_number": "256-837-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 CASTLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588257",
            "telephone_number": "256-837-5425",
            "fax_number": "256-837-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PERFORMANCE THERAPY AND REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-837-5425",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51518990",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J624",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dutton Dental, LLC (Dutton Dental)
• Emily Rae Dutton, NP-C
• Ethan Dutton
• Trella C. Dutton, D.D.S.
• Michael David Dye, A.T.C.
• E a McCleskey, DO, LLC
• Early Interactions, LLC
• Hannah Earnst
• Margaret Tiffanie Easley
• Hazel Marketta Eason, PHARMD

• Physical Therapy Clinic/Center in Madison, AL
• Providers in Madison, AL by specialty
• Physical Therapy Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.