Active NPI
Brian McMahon, PT
- Physical Therapist
- Camarillo, CA
National Provider Identifier
1114090222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 11071
- Practice address
- 1305 Del Norte Rd Ste 105
Camarillo, CA 93010-8367 - Phone
- (805) 981-3006
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 11071 | CA | Primary |
Addresses
Primary practice location
1305 Del Norte Rd Ste 105
Camarillo, CA 93010-8367
Mailing address
450 Rosewood Ave
Ste 105
Camarillo, CA 93010-5914
Phone (805) 981-3006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11071 | CA | MD | Professional Counselor |
| PT 11071 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486684800000",
"number": "1114090222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 ROSEWOOD AVE",
"address_2": "STE 105",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930105914",
"telephone_number": "805-981-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 DEL NORTE RD STE 105",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930108367",
"telephone_number": "805-981-3006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "BRIAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2017-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 11071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.