Nancy L. Poulalion, PTA

Primary specialty

SpecialistTaxonomy code 174400000X

License

AT4980 Issued in CA

Practice address

1000 Bristol St N Ste 25
Newport Beach, CA 92660-8917

Phone

(949) 250-1112

Fax

(949) 250-1401

NPI assigned

May 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prosport Physical Therapy Professionals Inc

  • Specialist
  • Costa Mesa, CA
  • NPI 1649223694
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154522506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BRISTOL ST N STE 25",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608917",
            "telephone_number": "949-250-1112",
            "fax_number": "949-250-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRISTOL ST N STE 25",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608917",
            "telephone_number": "949-250-1112",
            "fax_number": "949-250-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULALION",
        "first_name": "NANCY",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "AT4980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPIST ASSISTANT",
            "identifier": "AT4980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian J Porteous, D.C.
• Naomi Y Porter, PA-C
• David Porzio, M.D.
• Posc of Orange, LLC
• Post-Acute Care Physicians, Inc.
• Shabnam Pourhassani, L.AC.
• Payam Pourkashef, L.AC., DACM
• Douglas Lionel Powell Jr., MD
• Mark Power, M.A.
• Poyourow Professional Dental Corporation

• Specialist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.