Organization Active NPI

Peak Performance Physical Therapy

  • Orthopedic Physical Therapist
  • Prescott Valley, AZ
National Provider Identifier
1811060031
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
4304 Issued in AZ
Legal business name
PEAK PERFORMANCE PHYSICAL THERAPY
Practice address
6455 N. Viewpoint Dr. Ste 100
Prescott Valley, AZ 86314
Phone
(928) 775-8700
Fax
(928) 775-8726
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Paula Sue Lemmer
Title
Manager
Phone
(928) 775-8700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X 4304 AZ Primary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X AZ

Addresses

Primary practice location

6455 N. Viewpoint Dr. Ste 100
Prescott Valley, AZ 86314

Mailing address

6455 N. Viewpoint Dr. Ste 100
6455 Viewpoint Dr. Ste 100
Prescott Valley, AZ 86314
Phone (928) 775-8700

Other identifiers 1

IdentifierTypeStateIssuer
438467MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000259 AZ Part B Supplier - Clinic/Group Practice 7618880774 Receives reassigned benefits from 1 practitioner
Practice locations: Prescott Valley, AZ

National Provider Directory

National Provider Directory

Locations

2235 S US Highway 89
Ste B3
Chino Valley, AZ 86323
Phone (928) 583-9803

8008 E Yavapai Rd
Ste D
Prescott Valley, AZ 86314

8705 E Eastridge Rd
Ste A
Prescott Valley, AZ 86314

6455 N Viewpoint Dr
Ste 10
Prescott Vly, AZ 86314

6455 N Viewpoint Dr
Ste 100
Prescott Vly, AZ 86314
Phone (928) 775-8700

Practitioners & affiliated clinicians

Practitioners 4

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1811060031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 N. VIEWPOINT DR. STE 100",
            "address_2": "6455 VIEWPOINT DR. STE 100",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-775-8700",
            "fax_number": "928-775-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 N. VIEWPOINT DR. STE 100",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-775-8700",
            "fax_number": "928-775-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "LEMMER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "928-775-8700"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "4304",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "438467",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.