Active NPI
Nancy Lee Redgate, PT
- Physical Therapist
- Simi Valley, CA
National Provider Identifier
1194851626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11278
- Practice address
- 1690 Blackwall Dr
Simi Valley, CA 93063-3208 - Phone
- (805) 469-4561
- NPI assigned
- Feb 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | PT11278 | CA | Primary |
Addresses
Primary practice location
1690 Blackwall Dr
Simi Valley, CA 93063-3208
Mailing address
PO Box 4501
Thousand Oaks, CA 91359-1501
Phone (805) 469-4561
Other names 1
- Nancy Lee Miles
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT11278 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194851626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4501",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913591501",
"telephone_number": "805-469-4561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1690 BLACKWALL DR",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930633208",
"telephone_number": "805-469-4561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDGATE",
"first_name": "NANCY",
"middle_name": "LEE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT11278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "MILES",
"middle_name": "LEE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Simi Valley, CA
- Tessa Rawson
- Cynthia Amelia Ray, MPH, RD
- Deepa K Reddy, M.D.
- Muni Nanjunda Reddy, MD
- Shashi Kant Reddy, MD
- Linda Diane Reed, DPT
- Reenvision Aesthetics and Medspa
- Sadaf Regar, PA-C
- Regents of the University of California (UCLA Integrated Provider Network)
- Regents of the University of California (UCLA Integrated Provider Network)
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.