Prairie Performance Physical Therapy & Fitness, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PRAIRIE PERFORMANCE PHYSICAL THERAPY & FITNESS, LLC

Practice address

510 1St St E
Buffalo, SD 57720

Phone

(605) 641-3678

NPI assigned

Oct 31, 2019

Organization subpart

No

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

Authorized official

Name

Jacy Rae Buffington, DPTNPI 1023545423

Title

Owner/Physical Therapist

Phone

(605) 375-3039

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Practitioners 1

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

• Jacy Rae Buffington, PT, DPT, CERT DN

  • Physical Medicine & Rehabilitation Physician
  • Buffalo, SD
  • NPI 1023545423

  SD

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1922642016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12737 BROWN JOHNSON RD",
            "city": "BUFFALO",
            "state": "SD",
            "postal_code": "577206002",
            "telephone_number": "605-375-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 1ST ST E",
            "city": "BUFFALO",
            "state": "SD",
            "postal_code": "57720",
            "telephone_number": "605-641-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE PERFORMANCE PHYSICAL THERAPY & FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "BUFFINGTON",
        "authorized_official_first_name": "JACY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "605-375-3039",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Buffalo, SD
• Physical Therapy Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.