Active NPI
Finishline Physical Therapy Inc.
- Physical Therapy Clinic/Center
- Vista, CA
National Provider Identifier
1104816057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- PT22017
- Legal business name
- FINISHLINE PHYSICAL THERAPY INC.
- Practice address
- 969 S Santa Fe Ave Ste E2
Vista, CA 92083-6910 - Phone
- (760) 330-9995
- NPI assigned
- Oct 24, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary Raymond, P.T
- Title
- Physician
- Phone
- (323) 465-9180
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT22017 | CA | Primary |
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
969 S Santa Fe Ave Ste E2
Vista, CA 92083-6910
Mailing address
969 S Santa Fe Ave Ste E2
Vista, CA 92083-6910
Phone (760) 330-9995
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104816057 | Other | CA | AWAITING PROCESSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
419 N Larchmont Blvd
#34
Los Angeles, CA 90004
Phone (323) 465-9180
531 N Larchmont Blvd
Ste 2
Los Angeles, CA 90004
Phone (323) 465-9180
969 S Santa Fe Ave
Ste E2
Vista, CA 92083
Phone (760) 330-9995
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Los Angeles, CA
- NPI 1649241456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1551916800000",
"number": "1104816057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "969 S SANTA FE AVE STE E2",
"city": "VISTA",
"state": "CA",
"postal_code": "920836910",
"telephone_number": "760-330-9995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "969 S SANTA FE AVE STE E2",
"city": "VISTA",
"state": "CA",
"postal_code": "920836910",
"telephone_number": "760-330-9995"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FINISHLINE PHYSICAL THERAPY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-24",
"last_updated": "2019-03-07",
"status": "A",
"authorized_official_last_name": "RAYMOND",
"authorized_official_first_name": "GARY",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "323-465-9180",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "P.T"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "CA",
"license": "PT22017",
"primary": true
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AWAITING PROCESSING",
"identifier": "1104816057",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.