NPIMap

Organization Active NPI

Novato Back Care and Sports Physical Therapy

  • Orthopedic Physical Therapist
  • Novato, CA
National Provider Identifier
1093945230
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
NOVATO BACK CARE AND SPORTS PHYSICAL THERAPY
Practice address
165 Rowland Way
Suite 101
Novato, CA 94945-5038
Phone
(415) 898-1311
Fax
(415) 897-0741
NPI assigned
Jul 22, 2009
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Steven William Thompson, MPT, OCSNPI 1427016401
Title
Ceo
Phone
(415) 898-1311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

165 Rowland Way
Suite 101
Novato, CA 94945-5038

Mailing address

165 Rowland Way
Suite 101
Novato, CA 94945-5038
Phone (415) 898-1311

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ17635ZOtherCAMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

165 Rowland Way
Ste 101
Novato, CA 94945
Phone (415) 898-1311

Practitioners & affiliated clinicians

Practitioners 12

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": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1093945230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY",
            "address_2": "SUITE 101",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455038",
            "telephone_number": "415-898-1311",
            "fax_number": "415-897-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY",
            "address_2": "SUITE 101",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455038",
            "telephone_number": "415-898-1311",
            "fax_number": "415-897-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVATO BACK CARE AND SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-898-1311",
        "authorized_official_credential": "MPT, OCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ17635Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.