Active NPI
Loren J. Middag, RPT
- Physical Therapist
- Redlands, CA
National Provider Identifier
1215132576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT12634
- Practice address
- 500 N. Orange
Redlands, CA 92373 - Phone
- (951) 684-2874
- Fax
- (951) 684-2980
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- No
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 | PT12634 | CA | Primary |
Addresses
Primary practice location
500 N. Orange
Redlands, CA 92373
Mailing address
3191 Mission Inn Ave
Riverside, CA 92507
Phone (951) 684-2874
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT12634 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marketplace Physical Therapy Inc, a Professional Corporation | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Riverside, CA
- NPI 1285190942
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1215132576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3191 MISSION INN AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92507",
"telephone_number": "951-684-2874",
"fax_number": "951-684-2980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N. ORANGE",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92373",
"telephone_number": "951-684-2874",
"fax_number": "951-684-2980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDAG",
"first_name": "LOREN",
"middle_name": "J.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT12634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.