NPIMap

Organization Active NPI

Prime Home Physical Therapy P.C.

  • Physical Therapist
  • Tracy, CA
National Provider Identifier
1174913164
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRIME HOME PHYSICAL THERAPY P.C.
Practice address
1762 Schantz Way
Tracy, CA 95376-6742
Phone
(510) 410-7623
NPI assigned
Jan 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Authorized official

Name
Anthony Phillips, D.P.T.NPI 1639190044
Title
Owner
Phone
(510) 410-7623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1762 Schantz Way
Tracy, CA 95376-6742

Mailing address

1762 Schantz Way
Tracy, CA 95376-6742

National Provider Directory

National Provider Directory

Locations

3950 Valley Ave
Ste B
Pleasanton, CA 94566
Phone (209) 627-0342

Practitioners & affiliated clinicians

Practitioners 1

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": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1174913164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 SCHANTZ WAY",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953766742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 SCHANTZ WAY",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953766742",
            "telephone_number": "510-410-7623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HOME PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-410-7623",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.