Next Level Physical Therapy Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27666 Issued in CA

Legal business name

NEXT LEVEL PHYSICAL THERAPY INC.

Practice address

719 Southpoint Blvd
Suite a
Petaluma, CA 94954-1495

Phone

(707) 781-8062

Fax

(707) 981-8684

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

Kyle Jackson, PTNPI 1861597908

Title

Principal/Owner

Phone

(707) 781-8062

Specialties & licenses 1

Addresses

Other names 1

• Next Level Physical Therapy Performance and Fitness Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Kyle Jackson, PT

  • Physical Therapist
  • Petaluma, CA
  • NPI 1861597908
  Medicare reassignment Care Compare group NPD Authorized official
• Julia Rachelle Cratty, PT, DPT

  • Physical Therapist
  • Santa Rosa, CA
  • NPI 1417604745
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1003280801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 SOUTHPOINT BLVD",
            "address_2": "SUITE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541495",
            "telephone_number": "707-781-8062",
            "fax_number": "707-981-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 SOUTHPOINT BLVD",
            "address_2": "SUITE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541495",
            "telephone_number": "707-781-8062",
            "fax_number": "707-981-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXT LEVEL PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "PRINCIPAL/OWNER",
        "authorized_official_telephone_number": "707-781-8062",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Next Level Physical Therapy Performance and Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Herbert Newburger, MD
• Emma Newman
• Rachael Newman
• Sarah Newman
• Abriana Newton
• Huong Ngo
• Wenjamin Nguyen-Gilmore
• Eric Nguyen
• Kant Kim Luong Nguyen
• Lana Ngoc Nguyen, M.D.

• Physical Therapist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.