Backtogolf Performance Center, LLC

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

1029148 Issued in TX

Legal business name

BACKTOGOLF PERFORMANCE CENTER, LLC

Practice address

7401 State Highway 45
Austin, TX 78739-1901

Phone

(512) 371-7687

Fax

(512) 371-7601

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

M. Jay Platt, P.T.

Title

President

Phone

(512) 371-7687

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922202126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11318 ADEN CT",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787391589",
            "telephone_number": "512-371-7687",
            "fax_number": "512-371-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 STATE HIGHWAY 45",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787391901",
            "telephone_number": "512-371-7687",
            "fax_number": "512-371-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACKTOGOLF PERFORMANCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PLATT",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-371-7687",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1029148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0089GJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back Pocket Physical Therapy LLC
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• Kristen E Backe, PHARMD
• Kelli Rae Backhaus
• Joseph Backlund, PHARM.D.
• Beth Bacon, OTR
• Kenneth Terry Bacon, MD
• Emily Lynn Bacopulos
• Isabell Bacot, PA
• Tyler Joseph Badding, MD

• Sports Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Sports Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.