NPIMap

Organization Active NPI

Performance Physical Therapy & Sports Medicine Inc

  • Physical Therapist
  • Montgomery, TX
National Provider Identifier
1790952273
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1143378 Issued in TX
Legal business name
PERFORMANCE PHYSICAL THERAPY & SPORTS MEDICINE INC
Practice address
18445 Highway 105 W
Suite 103
Montgomery, TX 77356-6064
Phone
(936) 321-1101
Fax
(936) 321-1107
NPI assigned
May 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Authorized official

Name
Timothy Clayton Meekins, LPT
Title
Owner LPT Therapist in Charge
Phone
(936) 321-1101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1143378 TX Primary

Addresses

Primary practice location

18445 Highway 105 W
Suite 103
Montgomery, TX 77356-6064

Mailing address

PO Box 3064
Conroe, TX 77305-3064
Phone (936) 321-1101

Other identifiers 3

IdentifierTypeStateIssuer
1417997826OtherTXINDIVIDUAL NPI #
0078223OtherTXBLUE LINK #
8T6301OtherTXINDIVIDUAL BC/BS PROVIDER #

Other names 1

  • Performance Physical Therapy Other name

National Provider Directory

National Provider Directory

Locations

18445 Highway 105 W
Ste 103
Montgomery, TX 77356
Phone (936) 321-1101

19053 I 45 S
Ste B
Shenandoah, TX 77385
Phone (936) 321-1101

Practitioners & affiliated clinicians

Practitioners 2

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": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1790952273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3064",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773053064",
            "telephone_number": "936-321-1101",
            "fax_number": "936-321-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18445 HIGHWAY 105 W",
            "address_2": "SUITE 103",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773566064",
            "telephone_number": "936-321-1101",
            "fax_number": "936-321-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY & SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "MEEKINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "OWNER LPT  THERAPIST IN CHARGE",
        "authorized_official_telephone_number": "936-321-1101",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1143378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1417997826",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE LINK #",
            "identifier": "0078223",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BC/BS PROVIDER #",
            "identifier": "8T6301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.