Olympic Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20057 Issued in CA

Legal business name

OLYMPIC PHYSICAL THERAPY

Practice address

1 Blackfield Dr
Tiburon, CA 94920-2053

Phone

(415) 383-6789

Fax

(415) 383-6744

NPI assigned

Sep 28, 2006

Last updated

Sep 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff Harband, P.T.

Title

Ceo

Phone

(415) 383-6789

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey F. Harband, P.T.

  • Orthopedic Physical Therapist
  • Tiburon, CA
  • NPI 1932112141
  Medicare reassignment Care Compare group NPD
• Heather Rourke- Schlueter, PT

  • Orthopedic Physical Therapist
  • Tiburon, CA
  • NPI 1821271347
  Medicare reassignment Care Compare group NPD
• Pamela Johnson, PT

  • Physical Therapist
  • Sausalito, CA
  • NPI 1023111465
  NPD
• Marla Overton Kelly, MOT, OTR

  • Occupational Therapist
  • Tiburon, CA
  • NPI 1215080239
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1265523609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACKFIELD DR",
            "city": "TIBURON",
            "state": "CA",
            "postal_code": "949202053",
            "telephone_number": "415-383-6789",
            "fax_number": "415-383-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACKFIELD DR",
            "city": "TIBURON",
            "state": "CA",
            "postal_code": "949202053",
            "telephone_number": "415-383-6789",
            "fax_number": "415-383-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "HARBAND",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-383-6789",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF6085",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Mir, OTR/L
• Debbra Ann Montoya, PA-C
• Ilana Mazal Nachoum, PHYSICAL THERAPIST
• Eric E Nelson, DPT, OCS
• Kristen Nelson, DPT
• Sherrin Jean Packer-Rosenthal, LMFT, MSW,ASW, PPSC
• Herbert W. Peterson, M. D.
• Alicia Andreis Pflueger, D.C.
• Polly Ely, Inc. (Parent School)
• Portofino Labs, Inc (Because Market)

• Physical Therapist in Tiburon, CA
• Providers in Tiburon, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.