Active NPI
Cory Parker, DPT
- Physical Therapist
- Carlsbad, CA
National Provider Identifier
1194288126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT296440
- Practice address
- 3070 Madison St
Carlsbad, CA 92008-2310 - Phone
- (760) 434-6100
- NPI assigned
- Apr 8, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT296440 | CA | Primary |
Addresses
Primary practice location
3070 Madison St
Carlsbad, CA 92008-2310
Mailing address
3070 Madison St
Carlsbad, CA 92008-2310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330142586 | Other | CA | TAX ID |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | julianna.chavez@pthc-pt.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Los Gatos, CA 95032
Phone (866) 525-3175
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT296440 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barbara Jean Boutelle Carlsbad Physical Therapy | Physical Therapist | Past | Accepting new patients |
| Barbara Jean Boutelle Carlsbad Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Los Gatos, CA
- NPI 1689162166
-
- Physical Therapist
- San Diego, CA
- NPI 1699723098
-
- Physical Therapist
- San Diego, CA
- NPI 1841830700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1194288126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3070 MADISON ST",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920082310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3070 MADISON ST",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920082310",
"telephone_number": "760-434-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "CORY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-08",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT296440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "330142586",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "julianna.chavez@pthc-pt.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3070 Madison St",
"city": "Carlsbad",
"state": "CA",
"country_code": "US",
"postal_code": "920082310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.