NPIMap

Organization Active NPI

Body Center Physical Therapy, Inc

  • Orthopedic Physical Therapist
  • Claremont, CA
National Provider Identifier
1235224593
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 25533 Issued in CA
Legal business name
BODY CENTER PHYSICAL THERAPY, INC
Practice address
224 N Indian Hill Blvd
Claremont, CA 91711-4609
Phone
(909) 621-0447
Fax
(626) 821-5434
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Jeffrey Laurence Fairley, PT, DPT, OCSNPI 1285735431
Title
Owner
Phone
(626) 664-2827

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT25533 CA
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X PT 25533 CA
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X PT 25533 CA Primary

Addresses

Primary practice location

224 N Indian Hill Blvd
Claremont, CA 91711-4609

Mailing address

224 N Indian Hill Blvd
Claremont, CA 91711-4609
Phone (909) 621-0447

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070419000638 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4880799873 Receives reassigned benefits from 7 practitioners
Practice locations: Claremont, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1235224593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N INDIAN HILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114609",
            "telephone_number": "909-621-0447",
            "fax_number": "626-821-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N INDIAN HILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114609",
            "telephone_number": "909-621-0447",
            "fax_number": "626-821-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY CENTER PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "FAIRLEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LAURENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-664-2827",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25533",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT 25533",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 25533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.