SUMMIT SPORTS PERFORMANCE AND REHAB CENTER, PLLC (NPI# 1972915874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972915874 |
| Entity Type | Organization |
| Organization Name | SUMMIT SPORTS PERFORMANCE AND REHAB CENTER, PLLC |
| Practice Address |
2760 Rasmussen Rd Suites D2-d3 Park City UT 84098-5684 |
| Practice Telephone | 8017185378 |
| Mailing Telephone | 8017185378 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | DR. JESSICA J TIDSWELL (MANAGER) |
| Authorized Official Telephone | 8017185378 |
| Authorized Official Credential | PT, DPT, SCS, AT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5080663-4810 | UT | Ambulatory Health Care Facilities |
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5080663-2401 | UT | Ambulatory Health Care Facilities |
| Street Address |
2760 RASMUSSEN RD SUITES D2-D3 |
| City | PARK CITY |
| State | UT |
| Zip Code | 84098-5684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861402026 | Sari Ann Soutor Farhart | Psychologist | 2760 Rasmussen Rd, Ste 205, Park City, UT 84098-5684 | 2006-08-09 |
| 1073933966 | Peak Performance Physical Therapy, PC | Clinic/Center | 2760 Rasmussen Rd, D2-d3, Park City, UT 84098-5684 | 2014-04-18 |
| 1063761914 | Maesha Miller | Occupational Therapist | 2760 Rasmussen Rd, Summit Ctr, Bldg D, Park City, UT 84098-5684 | 2012-09-06 |
| 1083948343 | Rebecca Ellen Price | Marriage & Family Therapist | 2760 Rasmussen Rd, 200, Park City, UT 84098-5684 | 2009-09-18 |
| 1790925394 | Tyrene L Christopulos | Occupational Therapist | 2760 Rasmussen Rd, Park City, UT 84098-5684 | 2009-02-23 |
| 1689858631 | Kwinten Kemp | Counselor | 2760 Rasmussen Rd, Building D, Suite 205, Park City, UT 84098-5684 | 2007-12-27 |
| 1952593568 | Jessica J Tidswell | Physical Therapist | 2760 Rasmussen Rd, Suite D2-d3, Park City, UT 84098-5684 | 2007-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069532 | Natasha Nicolle Peterson | Nurse Practitioner | Stat Md, 1784 Uinta Way E, Park City, UT 84098 | 2019-02-19 |
| 1750732079 | Rebecca Hansen | Physical Therapist | 1640 W Redstone Center Dr, Suite 200, Park City, UT 84098 | 2016-06-28 |
| 1497126130 | Megan Franz | Counselor | 3100 Pinebrook Rd, Park City, UT 84098 | 2015-10-07 |
| 1568752541 | Kortney James Stirland | Pharmacist | 750 Round Valley Drive #203, Park City, UT 84098 | 2011-04-12 |
| 1265763379 | Amy S Koch | Physical Therapy Assistant | 1640 West Redstone Drive, Suite 200, Park City, UT 84098 | 2010-01-29 |
| 1134374648 | Donna B Fischer | General Practice | 6531 N Landmark Dr., Park City, UT 84098 | 2008-11-25 |
| 1962659458 | Patricia A Lindsay Phd Inc | Psychologist | 1743 W Redstone Ctr Dr, #115, Park City, UT 84098 | 2008-08-26 |
| 1437314291 | Jeffrey S Holverson | Internal Medicine | 6240 N Snowview Dr, Park City, UT 84098 | 2008-07-22 |
| 1578728515 | Blair Archbold Smith | Physical Therapist | 6880 Canyon Drive Court, Park City, UT 84098 | 2008-07-18 |
| 1821255274 | Beth Anita Rylands | Physical Therapy Assistant | 1640 W. Redstone Center Dr., Suite 200, Park City, UT 84098 | 2008-05-21 |
| Find all providers in zip 84098 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574177 | Motion Ut, LLC | Clinic/Center | 4554 Forestdale Dr Unit C16, Park City, UT 84098-1392 | 2020-09-28 |
| 1073933966 | Peak Performance Physical Therapy, PC | Clinic/Center | 2760 Rasmussen Rd, D2-d3, Park City, UT 84098-5684 | 2014-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1487261707 | Precision Jointcare LLC | Clinic/Center | 12523 S Creek Meadow Rd Ste 109, Riverton, UT 84065-7299 | 2020-09-30 |
| 1184231664 | Mountain Strong Spine and Performance | Clinic/Center | 1478 N 4925 W, Plain City, UT 84404-8300 | 2020-09-28 |
| 1881215085 | Move Well Age Well, LLC | Clinic/Center | 2223 S Highland Dr Ste E6-256, Salt Lake City, UT 84106-3672 | 2020-04-29 |
| 1215557434 | Basin Therapy LLC | Clinic/Center | 101 E 1875 S, Roosevelt, UT 84066-3828 | 2020-04-17 |
| 1780222893 | Well Being Pelvic Physical Therapy | Clinic/Center | 111 E 5600 S Ste 222, Murray, UT 84107-8164 | 2019-12-19 |
| 1265094619 | Recalibrate Physical Therapy | Clinic/Center | 3450 S 400 E, Salt Lake City, UT 84115-4604 | 2019-07-06 |
| 1598229155 | Neurorev Pllc | Clinic/Center | 520 N Market Place Dr Ste 200, Centerville, UT 84014-4904 | 2019-01-29 |
| 1104395821 | Color Country Physical Therapy LLC | Clinic/Center | 450 E Clinic Way, Ste B, Parowan, UT 84761 | 2018-11-26 |
| 1629556055 | Advanced Balance and Physical Therapy LLC | Clinic/Center | 856 Sage Dr Ste 301b, Cedar City, UT 84720 | 2018-07-28 |
| 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.