Organization Active NPI

Richard P Carr Physical Therapy Inc

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1114900263
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RICHARD P CARR PHYSICAL THERAPY INC
Practice address
2039 Forest Ave
#104
San Jose, CA 95128-4817
Phone
(408) 279-8501
Fax
(408) 279-8504
NPI assigned
Nov 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Anne Lasson
Title
Vice President
Phone
(408) 570-0510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X

Addresses

Primary practice location

2039 Forest Ave
#104
San Jose, CA 95128-4817

Mailing address

246 Sobrante Way
Sunnyvale, CA 94086-4807
Phone (408) 733-3670

Other identifiers 2

IdentifierTypeStateIssuer
2210753OtherFIRST HEALTH
ZZZ04942ZOtherCABLUESHIELD

Other names 1

  • Rehab Outcome Management Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001215 CA Part B Supplier - Clinic/Group Practice 9830182070 Receives reassigned benefits from 51 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Clara, CA; San Jose, CA; Palo Alto, CA; Morgan Hill, CA; Milpitas, CA

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

490 W El Camino Real
Mountain View, CA 94040
Phone (650) 961-7370

125 N Jackson Ave
Ste 204
San Jose, CA 95116
Phone (408) 254-7730

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1114900263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SOBRANTE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864807",
            "telephone_number": "408-733-3670",
            "fax_number": "408-245-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVE",
            "address_2": "#104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284817",
            "telephone_number": "408-279-8501",
            "fax_number": "408-279-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD P CARR PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "LASSON",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "408-570-0510"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2210753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "ZZZ04942Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab Outcome Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.