Individual provider Active NPI

Betty Clary-Trimm, PT 14194

  • Specialist
  • Brawley, CA
National Provider Identifier
1184764870
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT 14194 Issued in CA
Practice address
529 E St
Brawley, CA 92227-1930
Phone
(760) 344-9000
Fax
(760) 344-9191
NPI assigned
Feb 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Specialist 174400000X PT 14194 CA Primary

Addresses

Primary practice location

529 E St
Brawley, CA 92227-1930

Mailing address

PO Box 3204
El Centro, CA 92244-3204
Phone (760) 344-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226001232 CA Practitioner - Physical Therapist in Private Practice 4082500848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14194CAMDOptometrist
PT 14194CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Farid Zia Physical Therapist a Professional Corp CurrentSince Jul 1, 2006 Accepting new patients

Locations

529 E St
Brawley, CA 92227
Phone (760) 344-9000

420 Heffernan Ave
Ste 2B
Calexico, CA 92231
Phone (760) 355-7929

428 N Imperial Ave
El Centro, CA 92243
Phone (760) 353-3422

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184764870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3204",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922443204",
            "telephone_number": "760-344-9000",
            "fax_number": "760-344-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922271930",
            "telephone_number": "760-344-9000",
            "fax_number": "760-344-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY-TRIMM",
        "first_name": "BETTY",
        "name_prefix": "Ms.",
        "credential": "PT 14194",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 14194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.