NPIMap

Organization Active NPI

Peak Physical Therapy Clinic LLC

  • Physical Therapist
  • Brighton, MI
National Provider Identifier
1972963437
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011484 Issued in MI
Legal business name
PEAK PHYSICAL THERAPY CLINIC LLC
Practice address
455 E Grand River Ave
Suite 102
Brighton, MI 48116-1551
Phone
(810) 360-0806
Fax
(810) 360-0327
NPI assigned
Feb 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Amy Elizabeth Gallegos, DPTNPI 1316186216
Title
Owner/Physical Therapist
Phone
(810) 360-0806

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 5501011484 MI Primary

Addresses

Primary practice location

455 E Grand River Ave
Suite 102
Brighton, MI 48116-1551

Mailing address

455 E Grand River Ave
Suite 102
Brighton, MI 48116-1551
Phone (810) 360-0806

Other identifiers 1

IdentifierTypeStateIssuer
12221828OtherMICAQH PROVIDER NUMBER

Other names 1

  • Peak Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peak Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1972963437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E GRAND RIVER AVE",
            "address_2": "SUITE 102",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161551",
            "telephone_number": "810-360-0806",
            "fax_number": "810-360-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E GRAND RIVER AVE",
            "address_2": "SUITE 102",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161551",
            "telephone_number": "810-360-0806",
            "fax_number": "810-360-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PHYSICAL THERAPY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "810-360-0806",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12221828",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.