Individual provider Active NPI

Michelle Leanne McClure-Smith, PT, DPT

  • Physical Therapist
  • Temecula, CA
National Provider Identifier
1245563295
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36002 Issued in CA
Practice address
27450 Ynez Rd
Suite 120
Temecula, CA 92591-4671
Phone
(951) 695-5144
Fax
(951) 695-9345
NPI assigned
Sep 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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 PT36002 CA Primary

Addresses

Primary practice location

27450 Ynez Rd
Suite 120
Temecula, CA 92591-4671

Mailing address

24630 Washington Ave
Suite 200
Murrieta, CA 92562-6177
Phone (951) 696-9353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091023000350 CA Practitioner - Physical Therapist in Private Practice 6305983305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairbanks and Power Physical Therapy CorpGroup PAC ID 6406843481, 53 clinicians

Practice addresses (Care Compare)

25285 Madison Ave
Suite 103
Murrieta, CA 92562-8955
Phone (951) 600-0054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT36002CAMDLicensed Psychiatric Technician
36002CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks & Power Physical Therapy Corp. Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients

Locations

949 S State St
Hemet, CA 92543
Phone (951) 929-9890

2 Peters Canyon Rd
Ste 100
Irvine, CA 92606
Phone (949) 679-3988

29992 Hunter Rd
Ste 106
Murrieta, CA 92563
Phone (951) 299-2220

25285 Madison Ave
Ste 103
Murrieta, CA 92562
Phone (909) 600-2990

Organizations & group practices 1

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1245563295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27450 YNEZ RD",
            "address_2": "SUITE 120",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914671",
            "telephone_number": "951-695-5144",
            "fax_number": "951-695-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE-SMITH",
        "first_name": "MICHELLE",
        "middle_name": "LEANNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT36002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.