Individual provider Active NPI

Dennis K Spitzer, PT

  • Physical Therapist
  • Clovis, CA
National Provider Identifier
1174611040
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CA-PT17923 Issued in CA
Practice address
615 4TH St
Clovis, CA 93612-1124
Phone
(559) 322-5345
Fax
(559) 322-5041
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA-PT17923 CA Primary

Addresses

Primary practice location

615 4TH St
Clovis, CA 93612-1124

Mailing address

615 4TH St
Clovis, CA 93612-1124
Phone (559) 322-5345

Other identifiers 2

IdentifierTypeStateIssuer
0PT179230OtherCABLUE SHIELD
184456400OtherCADEPT. OF LABOR

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

LicenseStateTypeSpecialty
17923CAMDAcupuncturist
CA-PT17923CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1174611040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 4TH ST",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121124",
            "telephone_number": "559-322-5345",
            "fax_number": "559-322-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 4TH ST",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121124",
            "telephone_number": "559-322-5345",
            "fax_number": "559-322-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZER",
        "first_name": "DENNIS",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "CA-PT17923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0PT179230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR",
            "identifier": "184456400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.