NPIMap

Organization Active NPI

Active Rehab Physical Therapy, Inc.

  • Physical Therapist
  • American Canyon, CA
National Provider Identifier
1104914878
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27031 Issued in CA
Legal business name
ACTIVE REHAB PHYSICAL THERAPY, INC.
Practice address
3419 Broadway St
Suite H-10
American Canyon, CA 94503-1261
Phone
(707) 648-3144
Fax
(707) 644-0630
NPI assigned
Oct 10, 2006
Last updated
Aug 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Dr. Michael B. Scates, PT, MS, DPTNPI 1114943925
Title
President/Ceo
Phone
(707) 648-3144

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT27031 CA Primary

Addresses

Primary practice location

3419 Broadway St
Suite H-10
American Canyon, CA 94503-1261

Mailing address

1933 Banyon CMN
Livermore, CA 94550-4787
Phone (707) 648-3144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1104914878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 BANYON CMN",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504787",
            "telephone_number": "707-648-3144",
            "fax_number": "707-644-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 BROADWAY ST",
            "address_2": "SUITE H-10",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031261",
            "telephone_number": "707-648-3144",
            "fax_number": "707-644-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE REHAB PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "SCATES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-648-3144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, MS, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Canyon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.