Individual provider Active NPI

Patricia Ellen Tepper, PT.,M.S.

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1174671515
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9579 Issued in CA
Practice address
5260 Elvas Ave
Sacramento, CA 95819-2332
Phone
(916) 457-8801
Fax
(916) 457-7609
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT9579 CA Primary

Addresses

Primary practice location

5260 Elvas Ave
Sacramento, CA 95819-2332

Mailing address

784 Corvey Cir
Galt, CA 95632-3306
Phone (916) 457-8801

Other identifiers 1

IdentifierTypeStateIssuer
PT9579OtherCAPHYSICAL THERAPY LICENSE

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT9579CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Sacramento Physical Therapy, Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174671515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 CORVEY CIR",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956323306",
            "telephone_number": "916-457-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 ELVAS AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192332",
            "telephone_number": "916-457-8801",
            "fax_number": "916-457-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPPER",
        "first_name": "PATRICIA",
        "middle_name": "ELLEN",
        "credential": "PT.,M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT9579",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • 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.