NPIMap

Organization Active NPI

Performance Physical Medicine and Rehab

Doing business as Performance Physical Medicine

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville Beach, FL
National Provider Identifier
1720456254
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
PERFORMANCE PHYSICAL MEDICINE AND REHAB
Doing business as
Performance Physical Medicine
Practice address
333 5TH Ave N
Jacksonville Beach, FL 32250-5611
Phone
(904) 241-7907
Fax
(904) 241-1401
NPI assigned
Sep 15, 2015
Last updated
Sep 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Authorized official

Name
Dr. Casey G Morris, D.C.NPI 1174601173
Title
Owner/ Chiropractor
Phone
(904) 241-7907

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
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X Primary

Addresses

Primary practice location

333 5TH Ave N
Jacksonville Beach, FL 32250-5611

Mailing address

333 5TH Ave N
Jacksonville Beach, FL 32250-5611
Phone (904) 241-7907

Other names 1

  • Performance Physical Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1720456254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 5TH AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505611",
            "telephone_number": "904-241-7907",
            "fax_number": "904-241-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 5TH AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505611",
            "telephone_number": "904-241-7907",
            "fax_number": "904-241-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL MEDICINE AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "904-241-7907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.