Organization Active NPI

Onyx Physical Therapy and Wellness

Doing business as Onyx PT and Wellness

  • Physical Therapist
  • Encinitas, CA
National Provider Identifier
1023754322
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ONYX PHYSICAL THERAPY AND WELLNESS
Doing business as
Onyx PT and Wellness
Practice address
681 2ND St Ste 101
Encinitas, CA 92024-3523
Phone
(985) 778-5176
NPI assigned
May 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Jacqualynn Gordon, PT, DPT
Title
Owner/Physical Therapist
Phone
(801) 556-2135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

681 2ND St Ste 101
Encinitas, CA 92024-3523

Mailing address

1080 Normandy Hill LN
Encinitas, CA 92024-2238

Other practice location 1

1080 Normandy Hill Ln
Encinitas, CA 92024-2238
Phone (985) 778-5176

Other names 1

  • Onyx PT and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

681 2nd St
Ste 101
Encinitas, CA 92024
Phone (985) 778-5176

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1023754322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 NORMANDY HILL LN",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 2ND ST STE 101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243523",
            "telephone_number": "985-778-5176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1080 Normandy Hill Ln",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242238",
            "country_code": "US",
            "telephone_number": "985-778-5176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ONYX PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JACQUALYNN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-556-2135",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Onyx PT and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Onyx PT and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.