Active NPI
Cory Blackburn
- Physical Therapist
- Carlsbad, CA
National Provider Identifier
1063340495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2719 Loker Ave W Ste a
Carlsbad, CA 92010-6679 - Phone
- (760) 918-9200
- NPI assigned
- May 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | CA | Primary |
Addresses
Primary practice location
2719 Loker Ave W Ste a
Carlsbad, CA 92010-6679
Mailing address
10719 Tivoli CT
Bakersfield, CA 93311-2229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10719 Tivoli CT
Bakersfield, CA 93311-2229
1084 N El Camino Real
B 351
Encinitas, CA 92024-1334
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Function for Life Physical Therapy, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
2719 Loker Ave W
Ste A
Carlsbad, CA 92010
Phone (760) 918-9200
3257 Camino de los Coches
Ste 301
Carlsbad, CA 92009
Phone (760) 652-5236
Organizations & group practices 1
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.
-
- Physical Therapist
- Carlsbad, CA
- NPI 1568767309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1063340495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10719 TIVOLI CT",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933112229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2719 LOKER AVE W STE A",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920106679",
"telephone_number": "760-918-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "CORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-13",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.