NPIMap

Organization Active NPI

Elite Orthosport Physical Therapy

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1215280706
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ELITE ORTHOSPORT PHYSICAL THERAPY
Practice address
12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221
Phone
(310) 477-7774
Fax
(310) 477-7773
NPI assigned
Oct 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Heather Milligan, PTNPI 1144307067
Title
President
Phone
(310) 477-7774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221

Mailing address

12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221
Phone (310) 477-7774

National Provider Directory

National Provider Directory
Tax ID family
Elite Orthosport Performance Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1215280706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251221",
            "telephone_number": "310-477-7774",
            "fax_number": "310-477-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251221",
            "telephone_number": "310-477-7774",
            "fax_number": "310-477-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORTHOSPORT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-21",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "MILLIGAN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-477-7774",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.