Individual provider Active NPI

Mollie Anne Fitzsimmons, DPT

  • Physical Therapist
  • Carlsbad, CA
National Provider Identifier
1255446977
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24156 Issued in CA
Practice address
5650 El Camino Real
Ste 120
Carlsbad, CA 92008-7126
Phone
(760) 919-2688
Fax
(760) 502-6552
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 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 24156 CA Primary

Addresses

Primary practice location

5650 El Camino Real
Ste 120
Carlsbad, CA 92008-7126

Mailing address

5650 El Camino Real
Ste 120
Carlsbad, CA 92008-7126
Phone (760) 919-2688

Other names 1

  • Mollie Anne O'Neill 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
24156CAMDSpeech-Language Pathologist
008029CTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1255446977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 EL CAMINO REAL",
            "address_2": "STE 120",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087126",
            "telephone_number": "760-919-2688",
            "fax_number": "760-814-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 EL CAMINO REAL",
            "address_2": "STE 120",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087126",
            "telephone_number": "760-919-2688",
            "fax_number": "760-502-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "MOLLIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLIE",
            "last_name": "O'NEILL",
            "middle_name": "ANNE",
            "credential": "D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.