Individual provider Active NPI

Anthony Ly Schofer, P.T.A.

  • Physical Therapy Assistant
  • San Clemente, CA
National Provider Identifier
1205222494
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 10683 Issued in CA
Practice address
901 Calle Amanecer
Suite 320
San Clemente, CA 92673-6278
Phone
(949) 366-6785
Fax
(949) 366-6470
NPI assigned
Apr 14, 2015
Last updated
Apr 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 10683 CA Primary

Addresses

Primary practice location

901 Calle Amanecer
Suite 320
San Clemente, CA 92673-6278

Mailing address

901 Calle Amanecer
Suite 320
San Clemente, CA 92673-6278
Phone (949) 366-6785

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
AT 10683CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1205222494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "SUITE 320",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736278",
            "telephone_number": "949-366-6785",
            "fax_number": "949-366-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "SUITE 320",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736278",
            "telephone_number": "949-366-6785",
            "fax_number": "949-366-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOFER",
        "first_name": "ANTHONY",
        "middle_name": "LY",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 10683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.