Peak Physical Medicine and Wellness PLLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

PEAK PHYSICAL MEDICINE AND WELLNESS PLLC

Practice address

3200 Riverfront Dr Ste 207
Fort Worth, TX 76107-6534

Phone

(817) 882-6754

NPI assigned

Aug 19, 2024

Organization subpart

No

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

Authorized official

Name

Andre Marse, DCNPI 1154335552

Title

Manager

Phone

(504) 919-7360

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

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

• Andre Alphonse Marse, DC

  • Chiropractor
  • Fort Worth, TX
  • NPI 1154335552
  Medicare reassignment Care Compare group NPD Authorized official
• Alesha Marie Allsup, APRN

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1316772775
  Medicare reassignment Care Compare group NPD
• Ryan Wasilewski, DC

  • Chiropractor
  • Fort Worth, TX
  • NPI 1598187270

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jordan Alan Tittle, DC

  • Chiropractor
  • Lakeway, TX
  • NPI 1659902708
  NPD (past)
• Michael Edward McGovern, D.C.

  • Chiropractor
  • South Elgin, IL
  • NPI 1336365030
  NPD (past)

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1679305510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 RIVERFRONT DR STE 207",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761076534",
            "telephone_number": "817-882-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 RIVERFRONT DR STE 207",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076534",
            "telephone_number": "817-882-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PHYSICAL MEDICINE AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "MARSE",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-919-7360",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peacemakers
• David Owen Peach, AU.D.
• Audrey Nicole Peacock, DDS
• Robert Morgan Peacock, LCSW
• Peak Life Wellness Healthcare PLLC
• Peak Physical Therapy, LLC
• Peak Physical Therapy, LLC
• Peak Physical Therapy, LLC
• Natalee Peak
• Robert Peak, DDS

• Pain Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.