NPIMap

Organization Active NPI

The Performance Lab

  • Orthopedic Physical Therapist
  • Prospect, CT
National Provider Identifier
1679352884
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
THE PERFORMANCE LAB
Practice address
40 Union City Rd Ste D
Prospect, CT 06712-1585
Phone
(203) 232-5924
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Rebecca Lavaway, MSPTNPI 1851531016
Title
Ceo/Owner
Phone
(475) 233-3311

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X NU Primary

Addresses

Primary practice location

40 Union City Rd Ste D
Prospect, CT 06712-1585

Mailing address

103 Plank Rd
Prospect, CT 06712-1437
Phone (203) 232-5924

Other practice location 1

635 New Park Ave
West Hartford, CT 06110-1329
Phone (475) 316-1786

Other names 1

  • The Performance Lab LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

40 Union City Rd
Ste D
Prospect, CT 06712
Phone (203) 232-5924

635 New Park Ave
West Hartford, CT 06110
Phone (475) 316-1786

Practitioners & affiliated clinicians

Practitioners 2

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": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1679352884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PLANK RD",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121437",
            "telephone_number": "203-232-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNION CITY RD STE D",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121585",
            "telephone_number": "203-232-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 New Park Ave",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061101329",
            "country_code": "US",
            "telephone_number": "475-316-1786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE PERFORMANCE LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "LAVAWAY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "475-233-3311",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Performance Lab LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Prospect, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.