NPIMap

Organization Active NPI

Premier Performance Physical Therapy and Sports Medicine, L.L.C.

  • Physical Therapist
  • Concord, MA
National Provider Identifier
1780368605
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PREMIER PERFORMANCE PHYSICAL THERAPY AND SPORTS MEDICINE, L.L.C.
Practice address
50 Beharrell St
Concord, MA 01742-1749
Phone
(617) 932-1027
Fax
(617) 932-1476
NPI assigned
Jun 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Justin Wu, DPTNPI 1275872095
Title
Owner / Physical Therapist
Phone
(617) 932-1027

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 Primary

Addresses

Primary practice location

50 Beharrell St
Concord, MA 01742-1749

Mailing address

241 California St
Newton, MA 02458-1049
Phone (978) 500-3003

National Provider Directory

National Provider Directory
Tax ID family
Premier Performance Physical Therapy and2 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.

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": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1780368605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CALIFORNIA ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581049",
            "telephone_number": "978-500-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEHARRELL ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421749",
            "telephone_number": "617-932-1027",
            "fax_number": "617-932-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PERFORMANCE PHYSICAL THERAPY AND SPORTS MEDICINE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "617-932-1027",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.