Individual provider Active NPI

Gianna Niole Colla, PT DPT

  • Physical Therapist
  • Novato, CA
National Provider Identifier
1205213873
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39305 Issued in CA
Practice address
88 Rowland Way Ste 250
Novato, CA 94945-5062
Phone
(415) 898-1311
Fax
(415) 897-0741
NPI assigned
May 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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 39305 CA Primary

Addresses

Primary practice location

88 Rowland Way Ste 250
Novato, CA 94945-5062

Mailing address

88 Rowland Way Ste 250
Novato, CA 94945-5062
Phone (415) 898-1311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210419000749 CA Practitioner - Physical Therapist in Private Practice 5193133882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39305CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sport & Spine Therapy of Marin Inc Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients

Locations

88 Rowland Way
Ste 250
Novato, CA 94945
Phone (415) 484-1163

220 Greenfield Ave
San Anselmo, CA 94960
Phone (415) 457-4454

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1205213873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 ROWLAND WAY STE 250",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455062",
            "telephone_number": "415-898-1311",
            "fax_number": "415-897-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 ROWLAND WAY STE 250",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455062",
            "telephone_number": "415-898-1311",
            "fax_number": "415-897-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLA",
        "first_name": "GIANNA",
        "middle_name": "NIOLE",
        "credential": "PT DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.