NPIMap

Organization Active NPI

Precision Physical Therapy and Wellness Center, PC

  • Physical Therapy Clinic/Center
  • San Luis Obispo, CA
National Provider Identifier
1285173567
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
113096 Issued in CA
Legal business name
PRECISION PHYSICAL THERAPY AND WELLNESS CENTER, PC
Practice address
211 Tank Farm Rd Ste a
San Luis Obispo, CA 93401
Phone
(805) 714-5699
Fax
(805) 439-3901
NPI assigned
Feb 20, 2017
Last updated
May 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Authorized official

Name
Kristen Marie Carless, DPTNPI 1518265834
Title
Owner
Phone
(805) 714-5699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 113096 CA Primary

Addresses

Primary practice location

211 Tank Farm Rd Ste a
San Luis Obispo, CA 93401

Mailing address

211 Tank Farm Rd Ste a
San Luis Obispo, CA 93401-7509
Phone (805) 714-5699

Other practice location 1

211 Tank Farm Rd Ste B
San Luis Obispo, CA 93401
Phone (805) 714-5699

Other practice location 2

211 Tank Farm Rd Ste B
San Luis Obispo, CA 93401
Phone (805) 714-5699

Other practice location 3

211 Tank Farm Rd Ste B
San Luis Obispo, CA 93401
Phone (805) 714-5699

Other practice location 4

1194 Bedford Ct
San Luis Obispo, CA 93401-8606
Phone (805) 714-5699

Other practice location 5

211 Tank Farm Rd Ste A
San Luis Obispo, CA 93401
Phone (805) 714-5699 ext. 80571

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190621000654 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254665441 Receives reassigned benefits from 10 practitioners
Practice locations: Avila Beach, CA; San Luis Obispo, CA

National Provider Directory

National Provider Directory

Locations

211 Tank Farm Rd
Ste B
San Luis Obispo, CA 93401
Phone (805) 714-5699

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1285173567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 TANK FARM RD STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017509",
            "telephone_number": "805-714-5699",
            "fax_number": "805-439-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 TANK FARM RD STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-714-5699",
            "fax_number": "805-439-3901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Tank Farm Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93401",
            "country_code": "US",
            "telephone_number": "805-714-5699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Tank Farm Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93401",
            "country_code": "US",
            "telephone_number": "805-714-5699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Tank Farm Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93401",
            "country_code": "US",
            "telephone_number": "805-714-5699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1194 Bedford Ct",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934018606",
            "country_code": "US",
            "telephone_number": "805-714-5699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Tank Farm Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93401",
            "country_code": "US",
            "telephone_number": "805-714-5699 x80571",
            "fax_number": "805-439-3901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRECISION PHYSICAL THERAPY AND WELLNESS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "CARLESS",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-714-5699",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "113096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.