NPIMap

Organization Active NPI

Peak Physical Therapy, LLC

  • Physical Therapist
  • Wylie, TX
National Provider Identifier
1861887069
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEAK PHYSICAL THERAPY, LLC
Practice address
611 W Brown St
Suite 101
Wylie, TX 75098-5316
Phone
(972) 442-5287
Fax
(972) 442-3181
NPI assigned
Apr 3, 2015
Last updated
Jul 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-8923

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

611 W Brown St
Suite 101
Wylie, TX 75098-5316

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150724010198 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0648583344 Receives reassigned benefits from 253 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McKinney, TX; Plano, TX; Princeton, TX; Prosper, TX; Richardson, TX; Rowlett, TX; Fort Worth, TX; Royse City, TX…

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

3100 Independence Pkwy
Ste 321
Plano, TX 75075
Phone (469) 626-1007

5000 Main St
Ste 316
The Colony, TX 75056
Phone (469) 388-1139

611 W Brown St
Ste 101
Wylie, TX 75098
Phone (972) 442-5287

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1861887069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W BROWN ST",
            "address_2": "SUITE 101",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750985316",
            "telephone_number": "972-442-5287",
            "fax_number": "972-442-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.