Active NPI
One Life Physical Therapy Inc
- Physical Therapy Clinic/Center
- Coronado, CA
National Provider Identifier
1144851361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- ONE LIFE PHYSICAL THERAPY INC
- Practice address
- 160 C Ave
Coronado, CA 92118-1420 - Phone
- (281) 851-1613
- NPI assigned
- Jan 27, 2020
- Last updated
- Jan 8, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bryan Russell, DPT
- Title
- Owner
- Phone
- (281) 851-1613
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
160 C Ave
Coronado, CA 92118-1420
Mailing address
6621 Archwood Ave
San Diego, CA 92120-2401
Phone (281) 851-1613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
160 C Ave
Coronado, CA 92118
Phone (619) 228-9739
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Physical Medicine & Rehabilitation Physician
- Coronado, CA
- NPI 1407320260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736294400000",
"number": "1144851361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6621 ARCHWOOD AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921202401",
"telephone_number": "281-851-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 C AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921181420",
"telephone_number": "281-851-1613"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ONE LIFE PHYSICAL THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-27",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A",
"authorized_official_last_name": "RUSSELL",
"authorized_official_first_name": "BRYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "281-851-1613",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.