PERSONAL PERFORMANCE MEDICAL CORPORATION (NPI# 1083841597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083841597 |
| Entity Type | Organization |
| Organization Name | PERSONAL PERFORMANCE MEDICAL CORPORATION |
| Other Organization Name | FIT-WELL PROSTHETIC AND ORTHOTIC CENTER |
| Practice Address |
720 S River Rd Ste B205 St George UT 84790-5532 |
| Mailing Address |
50 S 900 E Ste 1 Salt Lake City UT 84102-1366 |
| Practice Telephone | 4356340070 |
| Practice Fax Number | 4356340070 |
| Mailing Telephone | 8013643100 |
| Mailing Fax Number | 8015755462 |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2011-05-25 |
| Authorized Official Name | MR. SCOTT E ALLEN (OWNER) |
| Authorized Official Telephone | 8013643100 |
| Authorized Official Credential | CERTIFIED PROSTH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Fit-Well Prosthetic and Orthotic Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528041662 | Personal Performance Medical Corporation | Prosthetic/Orthotic Supplier | 7575 S 900 E, Midvale, UT 84047-2343 | 2005-11-22 |
| 1114154622 | Personal Performance Medical Corporation | Prosthetic/Orthotic Supplier | 3354 Harrison Blvd, Suite 3, Ogden, UT 84403-1296 | 2009-06-11 |
| Street Address |
720 S RIVER RD STE B205 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-5532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992226302 | Freedom Prosthetic & Orthotics, LLC | Prosthetic/Orthotic Supplier | 356 E 600 S, St George, UT 84770-3949 | 2017-07-06 |
| 1275916777 | Andrus Prosthodontics Lc | Prosthetic/Orthotic Supplier | 640 E 700 S, Suite 104, St George, UT 84770-4023 | 2015-07-01 |
| 1952571358 | Advanced Physical Therapy | Prosthetic/Orthotic Supplier | 1490 E Foremaster Dr, Ste 110, St George, UT 84790-4488 | 2008-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578035713 | Feminine Forms LLC | Prosthetic/Orthotic Supplier | 345 S 500 E, American Fork, UT 84003-2525 | 2018-12-28 |
| 1841761095 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 4225 W Lake Park Blvd Ste 225, West Valley City, UT 84120-8213 | 2018-12-16 |
| 1114441441 | Asd Sleep LLC | Prosthetic/Orthotic Supplier | 1957 W Royal Hunte Dr, #250, Cedar City, UT 84720 | 2017-07-28 |
| 1356792634 | Fit Prosthetics LLC | Prosthetic/Orthotic Supplier | 154 E Myrtle Ave, Suite #100, Murray, UT 84107-4849 | 2016-06-28 |
| 1750760369 | Women Restore LLC | Prosthetic/Orthotic Supplier | 1171 Expressway Ln, Spanish Fork, UT 84660-1331 | 2015-05-28 |
| 1114306891 | Northwest Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 642 Kirby Ln Ste 103, Spanish Fork, UT 84660-5753 | 2015-05-27 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1851686588 | Walking Comfort LLC. | Prosthetic/Orthotic Supplier | 627 W. Marketplace Dr., Centerville, UT 84014-0000 | 2011-06-10 |
| 1205155777 | Jenco Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 7026 South Commerce Park Dr, Suite 2, Midvale, UT 84047-1026 | 2010-05-24 |
| 1275762254 | Paiute Indian Tribe of Utah | Prosthetic/Orthotic Supplier | 157 N Paiute Dr Reservation Rd., Kanosh, UT 84637 | 2009-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.