Individual provider Active NPI

Julia Fetherman, PT

  • Physical Therapist
  • Granada Hills, CA
National Provider Identifier
1225115017
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15465 Issued in CA
Practice address
11858 1/2 Balboa Blvd
Granada Hills, CA 91344-2753
Phone
(818) 217-4868
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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 PT15465 CA Primary

Addresses

Primary practice location

11858 1/2 Balboa Blvd
Granada Hills, CA 91344-2753

Mailing address

11858 1/2 Balboa Blvd
Granada Hills, CA 91344-2753
Phone (818) 217-4868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000566 CA Practitioner - Physical Therapist in Private Practice 7810921830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Valley Physical Therapy IncGroup PAC ID 4486895406, 4 clinicians

Practice addresses (Care Compare)

11858 /2 Balboa Blvd
Granada Hills, CA 91344-2762
Phone (818) 217-4868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT15465CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Valley Physical Therapy Inc Physical Therapist CurrentSince Apr 27, 2021 Accepting new patients
Steven Danchik Physical Therapy Pt5208 Physical Therapist Past Accepting new patients

Locations

11858 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 217-4868

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1225115017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11858 1/2 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753",
            "telephone_number": "818-217-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11858 1/2 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442753",
            "telephone_number": "818-217-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHERMAN",
        "first_name": "JULIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.