NPIMap

Organization Active NPI

Peak Performance Physical Therapy and Fitness

  • Physical Therapist
  • Coalville, UT
National Provider Identifier
1780731992
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5327836-2401 Issued in UT
Legal business name
PEAK PERFORMANCE PHYSICAL THERAPY AND FITNESS
Practice address
23 South Main Street
Coalville, UT 84017
Phone
(435) 654-3719
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Rodney Edward Wade, PTNPI 1164448080
Title
Owner
Phone
(435) 654-3719

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 5327836-2401 UT Primary

Addresses

Primary practice location

23 South Main Street
Coalville, UT 84017

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (888) 700-6907

Other identifiers 1

IdentifierTypeStateIssuer
529791445001MedicaidUT

National Provider Directory

National Provider Directory
Tax ID family
Peak Performance Physical Therapy and Fitness2 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 1

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1780731992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "888-700-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SOUTH MAIN STREET",
            "city": "COALVILLE",
            "state": "UT",
            "postal_code": "84017",
            "telephone_number": "435-654-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE PHYSICAL THERAPY AND FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-654-3719",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "5327836-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529791445001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coalville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.