NPIMap

Organization Active NPI

Hackley Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Fort Bragg, CA
National Provider Identifier
1235316993
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT14615 Issued in CA
Legal business name
HACKLEY PHYSICAL THERAPY, INC.
Practice address
501 Cypress St
Fort Bragg, CA 95437-5429
Phone
(707) 961-6191
Fax
(707) 964-6213
NPI assigned
Jan 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Authorized official

Name
Ms. Sheri L White-Hackley, P.T.NPI 1306098108
Title
Cfo
Phone
(707) 961-1606

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 PT14615 CA Primary

Addresses

Primary practice location

501 Cypress St
Fort Bragg, CA 95437-5429

Mailing address

31740 Cedar St
Fort Bragg, CA 95437-3922
Phone (707) 961-6191

Other practice location 1

18661 Old Coast Hwy
Fort Bragg, CA 95437-8260
Phone (707) 961-6191

National Provider Directory

National Provider Directory

Locations

Fort Bragg, CA 95437
Phone (707) 961-6191

501 Cypress St
Fort Bragg, CA 95437
Phone (707) 961-6191

Practitioners & affiliated clinicians

Practitioners 4

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": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1235316993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31740 CEDAR ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954373922",
            "telephone_number": "707-961-6191",
            "fax_number": "707-964-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CYPRESS ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375429",
            "telephone_number": "707-961-6191",
            "fax_number": "707-964-6213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18661 Old Coast Hwy",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "CA",
            "postal_code": "954378260",
            "country_code": "US",
            "telephone_number": "707-961-6191",
            "fax_number": "707-964-6213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HACKLEY PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "WHITE-HACKLEY",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-961-1606",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT14615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.