Individual provider Active NPI

Emily Richard, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1003100017
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37810 Issued in CA
Practice address
3115 Ocean Front Walk
San Diego, CA 92109-8729
Phone
(858) 488-3597
Fax
(858) 746-4041
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37810 CA Primary

Addresses

Primary practice location

3115 Ocean Front Walk
San Diego, CA 92109-8729

Mailing address

3639 Midway Dr Ste B286
San Diego, CA 92110-5254
Phone (858) 488-3597

Other names 1

  • Emily Anne Schivley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130213000251 CA Practitioner - Physical Therapist in Private Practice 9436303740 Reassigns benefits to 1 organization
I20210810001089 NV Practitioner - Physical Therapist in Private Practice 9436303740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golan Integrated Physical MedicineGroup PAC ID 2365678125, 16 clinicians

Practice addresses (Care Compare)

6592 N Decatur Blvd
Suite 115
Las Vegas, NV 89131-1038
Phone (702) 396-4993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Water and Sports Physical Therapy, Inc Physical Therapist CurrentSince Jan 1, 2012 Accepting new patients
Golan Integrated Physical Medicine CurrentSince Jul 1, 2021 Accepting new patients
Golan Integrated Physical Medicine CurrentSince Jul 1, 2021 Accepting new patients
Water and Sports Physical Therapy Past Accepting new patients

Locations

3115 Ocean Front Walk
San Diego, CA 92109
Phone (619) 922-6161

501 W Broadway
San Diego, CA 92101
Phone (619) 237-9027

3639 Midway Dr
#B286
San Diego, CA 92110

3639 Midway Dr
Ste B286
San Diego, CA 92110
Phone (858) 724-1747

321 N Pecos Rd
Ste 200
Henderson, NV 89074
Phone (702) 263-4925

3841 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 577-5829

6592 N Decatur Blvd
Ste 115
Las Vegas, NV 89131
Phone (702) 396-4993

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1003100017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MIDWAY DR STE B286",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105254",
            "telephone_number": "858-488-3597",
            "fax_number": "858-746-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 OCEAN FRONT WALK",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921098729",
            "telephone_number": "858-488-3597",
            "fax_number": "858-746-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "EMILY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "SCHIVLEY",
            "middle_name": "ANNE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.