NPIMap

Organization Active NPI

Athletic Physical Therapy Inc

  • Physical Therapist
  • Westlake Village, CA
National Provider Identifier
1114042165
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
DPT16701 Issued in CA
Legal business name
ATHLETIC PHYSICAL THERAPY INC
Practice address
30837 E Thousand Oaks Blvd
Westlake Village, CA 91362-4039
Phone
(818) 879-2091
Fax
(818) 879-1656
NPI assigned
Mar 20, 2007
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Stephen Clark, DPTNPI 1366567307
Title
Owner
Phone
(818) 879-2091

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
Physical Therapist 225100000X DPT16701 CA Primary

Addresses

Primary practice location

30837 E Thousand Oaks Blvd
Westlake Village, CA 91362-4039

Mailing address

30837 E Thousand Oaks Blvd
Westlake Village, CA 91362-4039

Other practice location 1

12424 Wilshire Blvd Ste 101
Los Angeles, CA 90025-1064
Phone (310) 826-2977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041202000150 CA Part B Supplier - Clinic/Group Practice 6507821436 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
Practice locations: Los Angeles, CA; Simi Valley, CA; Westlake Village, CA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

12424 Wilshire Blvd
Los Angeles, CA 90025
Phone (310) 571-8760

12424 Wilshire Blvd
Fl 1
Los Angeles, CA 90025
Phone (310) 826-2977

1464 Madera Rd
Simi Valley, CA 93065

1464 Madera Rd
Ste I1
Simi Valley, CA 93065
Phone (805) 306-1622

1464 Madera Rd
Unit I1
Simi Valley, CA 93065
Phone (805) 306-1622

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1114042165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30837 E THOUSAND OAKS BLVD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30837 E THOUSAND OAKS BLVD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624039",
            "telephone_number": "818-879-2091",
            "fax_number": "818-879-1656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12424 Wilshire Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900251064",
            "country_code": "US",
            "telephone_number": "310-826-2977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ATHLETIC PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-879-2091",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "DPT16701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.