NPIMap

Organization Active NPI

San Luis Physical Therapy & Orthopedic Rehabilitation Inc

Doing business as Movement For Life Physical Therapy

  • Physical Therapy Clinic/Center
  • Bakersfield, CA
National Provider Identifier
1104859230
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SAN LUIS PHYSICAL THERAPY & ORTHOPEDIC REHABILITATION INC
Doing business as
Movement For Life Physical Therapy
Practice address
8200 Stockdale Hwy Ste B1
Bakersfield, CA 93311-1004
Phone
(661) 827-8959
Fax
(661) 827-1779
NPI assigned
Jul 9, 2006
Last updated
Dec 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Authorized official

Name
Kelly Sanders, PTNPI 1316978182
Title
President
Phone
(805) 788-0805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

8200 Stockdale Hwy Ste B1
Bakersfield, CA 93311-1004

Mailing address

1106 Walnut St Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805

Other names 1

  • Movement For Life Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040117000206 CA Part B Supplier - Clinic/Group Practice 7618872946 Receives reassigned benefits from 85 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Luis Obispo, CA; Templeton, CA; Stockton, CA; Santa Maria, CA; Pismo Beach, CA; Paso Robles, CA; Morro Bay, CA; Lodi, CA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1104859230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 STOCKDALE HWY STE B1",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933111004",
            "telephone_number": "661-827-8959",
            "fax_number": "661-827-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS PHYSICAL THERAPY & ORTHOPEDIC REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-788-0805",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Movement For Life Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.

Verify at the official NPI Registry.