Individual provider Active NPI

Philip Leslie Stoddard, PT

  • Physical Therapist
  • Auburn, CA
National Provider Identifier
1275533739
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15599 Issued in CA
Practice address
295 Grass Valley Hwy
Auburn, CA 95603-4533
Phone
(530) 888-8326
Fax
(530) 888-1920
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 15599 CA Primary

Addresses

Primary practice location

295 Grass Valley Hwy
Auburn, CA 95603-4533

Mailing address

295 Grass Valley Hwy
Auburn, CA 95603-4533
Phone (530) 888-8326

Other identifiers 1

IdentifierTypeStateIssuer
13067OtherNONE

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
15599CAMDPhysical Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275533739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 GRASS VALLEY HWY",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956034533",
            "telephone_number": "530-888-8326",
            "fax_number": "530-888-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 GRASS VALLEY HWY",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956034533",
            "telephone_number": "530-888-8326",
            "fax_number": "530-888-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "PHILIP",
        "middle_name": "LESLIE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "15599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "13067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.