Organization Active NPI

Peak Performance Sports Medicine Inc

  • Physical Therapist
  • Green River, WY
National Provider Identifier
1902095375
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEAK PERFORMANCE SPORTS MEDICINE INC
Practice address
140 Commerce Drive
Green River, WY 82935
Phone
(307) 875-8492
Fax
(307) 875-7389
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Authorized official

Name
Hayley M Strauss, MPTNPI 1487873782
Title
President
Phone
(307) 875-8492

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

140 Commerce Drive
Green River, WY 82935

Mailing address

PO Box 1497
Green River, WY 82935-1497
Phone (307) 875-8492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080708000067 WY Part B Supplier - Clinic/Group Practice 4789756818 Receives reassigned benefits from 1 practitioner
Practice locations: Green River, WY

National Provider Directory

National Provider Directory

Locations

140 Commerce Dr
Green River, WY 82935
Phone (303) 875-8492

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1902095375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1497",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829351497",
            "telephone_number": "307-875-8492",
            "fax_number": "307-875-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COMMERCE DRIVE",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "82935",
            "telephone_number": "307-875-8492",
            "fax_number": "307-875-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "STRAUSS",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-875-8492",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green River, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.