Peak Form LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PEAK FORM LLC

Practice address

8225 W 20TH St
Greeley, CO 80634-3037

Phone

(720) 716-4518

Fax

(833) 971-1890

NPI assigned

Oct 28, 2024

Last updated

Oct 28, 2024By 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

Jeanette Hrubes

Title

Ceo

Phone

(720) 716-4518

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Brighton, CO
  • NPI 1811018914

  O20120831000550

  Same enrollment
• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Broomfield, CO
  • NPI 1831863117

  O20120831000550

  Same enrollment
• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Boulder, CO
  • NPI 1982718003

  O20120831000550

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Peak Form LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Peak Form LLC

  • Occupational Medicine Physician
  • Wheat Ridge, CO
  • NPI 1174441703
  NPD tax ID
• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Brighton, CO
  • NPI 1811018914
  NPD tax ID
• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Broomfield, CO
  • NPI 1831863117
  NPD tax ID
• Peak Form LLC

  dba Peak Form Medical Clinic

  • Physical Medicine & Rehabilitation Physician
  • Boulder, CO
  • NPI 1982718003
  NPD tax ID

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Beth Bohr, DPT

  • Physical Therapist
  • Lakewood, CO
  • NPI 1689236713
  NPD
• John Gregory Clayton, PT, DPT

  • Orthopedic Physical Therapist
  • Brighton, CO
  • NPI 1972092005
  NPD
• Kyle Cormican

  • Physical Therapist
  • Brighton, CO
  • NPI 1336998897
  NPD
• Charalampos Fotiou

  • Orthopedic Physical Therapist
  • Brighton, CO
  • NPI 1477092849
  NPD
• Sydney Davidson Haynes, PT, DPT

  • Physical Therapist
  • Longmont, CO
  • NPI 1821809641
  NPD
• John Levhofer, DPT

  • Physical Therapist
  • Boulder, CO
  • NPI 1063175776
  NPD
• Thaddeus Lin

  • Physical Therapist
  • Brighton, CO
  • NPI 1548832918
  NPD
• Christopher Michael Lindberg, PT

  • Physical Therapist
  • Longmont, CO
  • NPI 1275659419
  NPD
• Jennifer McLaggan, PT, DPT

  • Physical Therapist
  • Brighton, CO
  • NPI 1104277466
  NPD
• Lance Moore, PT, DPT

  • Physical Therapist
  • Brighton, CO
  • NPI 1154701928
  NPD
• Harmony Mueth, PT

  • Physical Therapist
  • Brighton, CO
  • NPI 1295575181
  NPD
• Carol Passarelli, PT, DPT

  • Physical Therapist
  • Boulder, CO
  • NPI 1376034702
  NPD

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1851113385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E 1ST AVE UNIT A",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800203792",
            "telephone_number": "720-716-4518",
            "fax_number": "888-971-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 W 20TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343037",
            "telephone_number": "720-716-4518",
            "fax_number": "833-971-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK FORM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "HRUBES",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-716-4518"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Payne, ATC
• Alison Payton, MA
• Thomas J Pazik, MD
• PDR Greeley PLLC (Greeley Kids Dental and Orthodontics)
• Peaceful Paws Therapy, LLC
• Peake Wellness Center
• Pearle Vision Inc (Pearle Vision #C6310)
• Ethan Pearson
• Erin Michelle Peck, PHARMD
• Emma Rose Pedersen

• Physical Medicine & Rehabilitation Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• Physical Medicine & Rehabilitation Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.