NPIMap

Organization Active NPI

Richard P. Carr Physical Therapy Inc

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1033192190
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RICHARD P. CARR PHYSICAL THERAPY INC
Practice address
25 N 14TH St
Ste 550
San Jose, CA 95112-6204
Phone
(408) 294-3922
Fax
(408) 294-4657
NPI assigned
Nov 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Authorized official

Name
Mr. Jonathan Dockery
Title
Vice President of Revenue Cycle
Phone
(760) 602-4105

Specialties & licenses 1

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

Addresses

Primary practice location

25 N 14TH St
Ste 550
San Jose, CA 95112-6204

Mailing address

PO Box 612260
San Jose, CA 95161-2260
Phone (877) 325-2776

Other identifiers 4

IdentifierTypeStateIssuer
196223400OtherCADOL
8157014OtherCAAETNA
2534479OtherCACIGNA
ZZZ60364ZOtherCABLUESHIELD

Other names 1

  • Performance Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Performance Physical Therapy10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15215 National Ave
Los Gatos, CA 95032

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1033192190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951612260",
            "telephone_number": "877-325-2776",
            "fax_number": "408-945-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N 14TH ST",
            "address_2": "STE 550",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126204",
            "telephone_number": "408-294-3922",
            "fax_number": "408-294-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD P. CARR PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "DOCKERY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF REVENUE CYCLE",
        "authorized_official_telephone_number": "760-602-4105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "196223400",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8157014",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2534479",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "ZZZ60364Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.