Performance Physical Therapy Inc

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT21013 Issued in FL

Legal business name

PERFORMANCE PHYSICAL THERAPY INC

Practice address

150 Southpark Blvd
Suite 201
St Augustine, FL 32086-5190

Phone

(904) 824-7787

Fax

(904) 429-0318

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Karen L Haseltine

Title

C.E.O.

Phone

(904) 824-7787

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laurie Kay Neal, PT, DPT

  • Physical Therapist
  • St Augustine, FL
  • NPI 1871868885
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1871694919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SOUTHPARK BLVD",
            "address_2": "SUITE 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865190",
            "telephone_number": "904-824-7787",
            "fax_number": "904-429-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SOUTHPARK BLVD",
            "address_2": "SUITE 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865190",
            "telephone_number": "904-824-7787",
            "fax_number": "904-429-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "HASELTINE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "904-824-7787",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT21013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "QV9",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosalee Perez-Teel, APRN
• Brenda Perez, PTA
• Melisa Perez
• Monica Perez
• Myriam C Perez, M.D.
• Performance Science and Rehab
• Alisha Perkins, BA
• Brandon Edward Perkins
• Amanda Quigley Perrin, R.D.
• Emily Perry, LCSW

• Orthopedic Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.