Active NPI
Joan Terry Plevin, PT, DC
- Orthopedic Physical Therapist
- Lake Forest, CA
National Provider Identifier
1154409688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT7100
- Practice address
- 22431 Goldrush
Lake Forest, CA 92630-4308 - Phone
- (949) 380-1445
- Fax
- (949) 380-7723
- NPI assigned
- Nov 1, 2006
- Last updated
- May 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT7100 | CA | Primary |
| Ergonomics Physical Therapist | 2251E1200X | PT7100 | CA | |
| Rehabilitation Chiropractor | 111NR0400X | DC16812 | CA | |
| Orthopedic Chiropractor | 111NX0800X | DC16812 | CA |
Addresses
Primary practice location
22431 Goldrush
Lake Forest, CA 92630-4308
Mailing address
22431 Goldrush
Lake Forest, CA 92630-4308
Phone (949) 380-1445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00PT71000 | Other | CA | BLUE SHIELD |
Other names 1
- Dr. Joan Terry Plevin
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 |
|---|---|---|---|
| DC16812 | CA | MD | Orthopedic Chiropractor |
| PT7100 | CA | MD | Ergonomics Physical Therapist |
| 7100 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1154409688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22431 GOLDRUSH",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926304308",
"telephone_number": "949-380-1445",
"fax_number": "949-380-7723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22431 GOLDRUSH",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926304308",
"telephone_number": "949-380-1445",
"fax_number": "949-380-7723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLEVIN",
"first_name": "JOAN",
"middle_name": "TERRY",
"name_prefix": "Dr.",
"credential": "PT, DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT7100",
"primary": true
},
{
"code": "2251E1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Ergonomics",
"state": "CA",
"license": "PT7100",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "DC16812",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "CA",
"license": "DC16812",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00PT71000",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOAN",
"last_name": "PLEVIN",
"middle_name": "TERRY",
"prefix": "DR.",
"credential": "D.C.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.