Organization Active NPI

Hairston & Daley Physical Therapy, a Professional Corporation

  • Orthopedic Physical Therapist
  • Orange, CA
National Provider Identifier
1154327922
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION
Practice address
1178 N Tustin St
Orange, CA 92867-6006
Phone
(714) 289-7790
Fax
(714) 289-7786
NPI assigned
Jun 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Mrs. Melanie M Eklund
Title
Office Manager
Phone
(714) 289-7790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

1178 N Tustin St
Orange, CA 92867-6006

Mailing address

1178 N Tustin St
Orange, CA 92867-6006
Phone (714) 289-7790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061102000386 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5294706297 Receives reassigned benefits from 1 practitioner
Practice locations: Orange, CA

National Provider Directory

National Provider Directory

Locations

1178 N Tustin St
Orange, CA 92867
Phone (714) 289-7780

2670 N Main St
Ste 150
Santa Ana, CA 92705
Phone (714) 543-0542

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1154327922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928676006",
            "telephone_number": "714-289-7790",
            "fax_number": "714-289-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928676006",
            "telephone_number": "714-289-7790",
            "fax_number": "714-289-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAIRSTON & DALEY PHYSICAL THERAPY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "EKLUND",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-289-7790",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.