Peak Action Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-131 Issued in ID

Legal business name

PEAK ACTION PHYSICAL THERAPY

Practice address

927 Sagewood PL
Pocatello, ID 83201-2719

Phone

(208) 251-9831

NPI assigned

Apr 27, 2011

Last updated

Apr 27, 2011By 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

Colin Rico Benedetti, DPT

Title

Owner/Ceo

Phone

(208) 251-9831

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1861783656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4269",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054269",
            "telephone_number": "208-251-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 SAGEWOOD PL",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012719",
            "telephone_number": "208-251-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK ACTION PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "BENEDETTI",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "RICO",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "208-251-9831",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Pocatello, ID
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.