Proformance Therapy and Wellness LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFORMANCE THERAPY AND WELLNESS LLC

Practice address

1104 Annie Ruth Jamar St
Athens, AL 35611-4494

Phone

(256) 203-3804

Fax

(256) 513-9952

NPI assigned

Jun 7, 2022

Organization subpart

Yes

Parent organization

PROFORMANCE THERAPY AND WELLNESS LLCAs reported in NPPES

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

Authorized official

Name

Maggie Duggan, DPTNPI 1255759015

Title

Owner

Phone

(256) 203-3804

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Tax ID family

Proformance Therapy and Wellness LLC2 organizations share this tax ID, including this one

Part of

Proformance Therapy and Wellness LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Proformance Therapy and Wellness LLC

  • Physical Therapist
  • Huntsville, AL
  • NPI 1770064990
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Proformance Therapy and Wellness LLC

  • Physical Therapist
  • Huntsville, AL
  • NPI 1770064990
  NPPES parent name

Practitioners 5

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

• Maggie Duggan, DPT

  • Physical Therapist
  • Huntsville, AL
  • NPI 1255759015
  Medicare reassignment Care Compare group NPD Authorized official
• Riley Alexandria Barrett, DPT

  • Physical Therapist
  • Huntsville, AL
  • NPI 1114596293
  Medicare reassignment Care Compare group NPD
• Jonathan Sowell, PT, DPT

  • Physical Therapist
  • Harker Heights, TX
  • NPI 1578174645

  AL

  Medicare reassignment Care Compare group NPD
• Marie Whitt

  • Physical Therapist
  • Fenton, MI
  • NPI 1295210086

  AL

  Medicare reassignment Care Compare group NPD
• Anthony Alan Southorn, PT, DPT

  • Physical Therapist
  • Cullman, AL
  • NPI 1013540822
  Medicare reassignment NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1942939731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 BEL AIR RD SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358023154",
            "telephone_number": "256-203-3804",
            "fax_number": "256-513-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 ANNIE RUTH JAMAR ST",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356114494",
            "telephone_number": "256-203-3804",
            "fax_number": "256-513-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFORMANCE THERAPY AND WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFORMANCE THERAPY AND WELLNESS LLC",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-203-3804",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mduggan@proformancetherapyandwellness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "162 Export Cir NW",
            "city": "Huntsville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "358063916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Athens, AL
• Providers in Athens, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.