Individual provider Active NPI

Karen Ellen Guerin, P.T.

  • Orthopedic Physical Therapist
  • San Diego, CA
National Provider Identifier
1235161050
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501014500 Issued in MI
Practice address
12171 World Trade Dr
San Diego, CA 92128-3709
Phone
(858) 674-4480
Fax
(858) 674-0769
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20688 CA
Orthopedic Physical Therapist 2251X0800X 5501014500 MI Primary
Sports Physical Therapist 2251S0007X 5501014500 MI
Orthopedic Physical Therapist 2251X0800X PT20688 CA

Addresses

Primary practice location

12171 World Trade Dr
San Diego, CA 92128-3709

Mailing address

1149 Hill Line Trail
Bloomfield Township, MI 48301
Phone (858) 382-9417

Other names 1

  • Ms. Karen Ellen McClure Former name

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
5501014500MIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Scalone PT, Inc Physical Therapist PastSince Feb 17, 2010 Accepting new patients
Fit Athletic CMR LLC Past Accepting new patients

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1235161050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HILL LINE TRAIL",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "858-382-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12171 WORLD TRADE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283709",
            "telephone_number": "858-674-4480",
            "fax_number": "858-674-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "KAREN",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "20688",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501014500",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MI",
            "license": "5501014500",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT20688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "MCCLURE",
            "middle_name": "ELLEN",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.