NPIMap

Organization Active NPI

Proformance Therapy and Wellness LLC

  • Physical Therapist
  • Huntsville, AL
National Provider Identifier
1770064990
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH6560 Issued in AL
Legal business name
PROFORMANCE THERAPY AND WELLNESS LLC
Practice address
162 Export Cir NW
Huntsville, AL 35806-3916
Phone
(256) 203-3804
Fax
(256) 513-9952
NPI assigned
Aug 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Dr. Maggie Ann Duggan, DPTNPI 1255759015
Title
Owner
Phone
(706) 410-0255

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PTH6560 AL Primary

Addresses

Primary practice location

162 Export Cir NW
Huntsville, AL 35806-3916

Mailing address

216 Bel Air Rd SE
Huntsville, AL 35802-3154
Phone (256) 203-3804

Other practice location 1

1104 Annie Ruth Jamar St
Athens, AL 35611-4494
Phone (256) 203-3804

National Provider Directory

National Provider Directory
Tax ID family
Proformance Therapy and Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1104 Annie Ruth Jamar St
Athens, AL 35611
Phone (256) 203-3804

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1535155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1770064990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 BEL AIR RD SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358023154",
            "telephone_number": "256-203-3804",
            "fax_number": "256-513-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 EXPORT CIR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358063916",
            "telephone_number": "256-203-3804",
            "fax_number": "256-513-9952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 Annie Ruth Jamar St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356114494",
            "country_code": "US",
            "telephone_number": "256-203-3804",
            "fax_number": "256-513-9952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFORMANCE THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-25",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-410-0255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH6560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

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