Organization Active NPI

Asis Physical Therapy, Inc.

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1023269222
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
394995 Issued in CA
Legal business name
ASIS PHYSICAL THERAPY, INC.
Practice address
11848 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2417
Phone
(888) 673-2263
NPI assigned
Oct 6, 2008
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Dr. Vanessa Marie Jackson, DPT
Title
Doctor of Physical Therapy
Phone
(858) 349-4869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 394995 CA Primary

Addresses

Primary practice location

11848 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2417

Mailing address

11848 Benardo Plaza CT
Suite 100
San Diego, CA 92128
Phone (858) 349-4859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090813000269 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1951455765 Receives reassigned benefits from 14 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

10545 Scripps Poway Pkwy
San Diego, CA 92131
Phone (858) 217-2496

10545 Scripps Poway Pkwy
Ste C
San Diego, CA 92131

11848 Bernardo Plaza Ct
Ste 100
San Diego, CA 92128
Phone (858) 217-2496

1828 Garnet Ave
San Diego, CA 92109
Phone (858) 217-2496

2206 Balboa Ave
San Diego, CA 92109
Phone (858) 274-6633

3830 Valley Centre Dr
Ste 701
San Diego, CA 92130
Phone (858) 217-2496

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1023269222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11848 BENARDO PLAZA CT",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92128",
            "telephone_number": "858-349-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11848 BERNARDO PLAZA CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282417",
            "telephone_number": "888-673-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASIS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "858-349-4869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "394995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 24, 2017; 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.