Impakt Performance Medicine LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

IMPAKT PERFORMANCE MEDICINE LLC

Practice address

2040 E Foundry Way
Wasilla, AK 99654-8256

Phone

(907) 315-6046

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tiffiny Wohlers

Title

Owner

Phone

(907) 315-6046

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1801700760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 E FOUNDRY WAY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548256",
            "telephone_number": "907-315-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E FOUNDRY WAY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548256",
            "telephone_number": "907-315-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPAKT PERFORMANCE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "WOHLERS",
        "authorized_official_first_name": "TIFFINY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-315-6046"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.