NPIMap

Organization Active NPI

Prime Therapies Inc.

Doing business as Prime Performance and Physio

  • Physical Therapist
  • Bozeman, MT
National Provider Identifier
1891168001
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRIME THERAPIES INC.
Doing business as
Prime Performance and Physio
Practice address
58 Silver Leaf LN
Bozeman, MT 59718-9625
Phone
(406) 599-9518
Fax
(406) 545-3394
NPI assigned
Nov 10, 2015
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Billy J. McClenahan, DPTNPI 1508203548
Title
Owner
Phone
(406) 599-9518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTP-PT-LIC-9412 MT
Physical Therapist 225100000X Primary

Addresses

Primary practice location

58 Silver Leaf LN
Bozeman, MT 59718-9625

Mailing address

58 Silver Leaf LN
Bozeman, MT 59718-9625
Phone (406) 599-9518

Other names 1

  • Prime Performance and Physio Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160503000868 MT Part B Supplier - Clinic/Group Practice 0042519696 Receives reassigned benefits from 4 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

253 Village Center Ln
Bozeman, MT 59718
Phone (406) 599-9518

58 Silver Leaf Ln
Bozeman, MT 59718
Phone (406) 599-9518

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1891168001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 SILVER LEAF LN",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189625",
            "telephone_number": "406-599-9518",
            "fax_number": "406-545-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 SILVER LEAF LN",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189625",
            "telephone_number": "406-599-9518",
            "fax_number": "406-545-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME THERAPIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "MCCLENAHAN",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-599-9518",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-9412",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Performance and Physio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prime Performance and Physio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.