Individual provider Active NPI

Indu Krishna, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1184857708
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
35926 Issued in CA
Practice address
4411 30TH St Ste 100
San Diego, CA 92116-4286
Phone
(619) 261-6049
NPI assigned
Aug 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 35926 CA Primary

Addresses

Primary practice location

4411 30TH St Ste 100
San Diego, CA 92116-4286

Mailing address

4411 30TH St Ste 100
San Diego, CA 92116-4286
Phone (619) 261-6049

Other practice location 1

752 Medical Center Ct Ste 303
Chula Vista, CA 91911-6661
Phone (619) 591-7900

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
35926CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Chula Vista Medical Center Past Accepting new patients
Embody Yoga & Physical Therapy Centers Inc Physical Therapist PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1251590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1184857708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 30TH ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164286",
            "telephone_number": "619-261-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 30TH ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164286",
            "telephone_number": "619-261-6049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "752 Medical Center Ct Ste 303",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919116661",
            "country_code": "US",
            "telephone_number": "619-591-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNA",
        "first_name": "INDU",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-30",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "35926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.