Active NPI
Mark Winston Nolte, PT
- Physical Therapist
- Santa Ana, CA
National Provider Identifier
1265417109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20582
- Practice address
- 2101 E 4TH St
Ste 170
Santa Ana, CA 92705-3814 - Phone
- (714) 558-3977
- Fax
- (714) 558-0308
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT20582 | CA | Primary |
Addresses
Primary practice location
2101 E 4TH St
Ste 170
Santa Ana, CA 92705-3814
Mailing address
200 Newport Center Dr
Ste 213
Newport Beach, CA 92660-7501
Phone (949) 644-1322
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT20582 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eggleton & Langton Physical Therapy Management Services | Physical Therapist | Past | Accepting new patients |
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.
-
dba PRN Desert Rehabilitation Institute
- Physical Therapist
- Calexico, CA
- NPI 1851347686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1265417109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NEWPORT CENTER DR",
"address_2": "STE 213",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607501",
"telephone_number": "949-644-1322",
"fax_number": "949-644-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 E 4TH ST",
"address_2": "STE 170",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053814",
"telephone_number": "714-558-3977",
"fax_number": "714-558-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLTE",
"first_name": "MARK",
"middle_name": "WINSTON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT20582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.