Individual provider Active NPI

Theresa Locke, P.T.

  • Physical Therapist
  • Angels Camp, CA
National Provider Identifier
1295750792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
OPT132160 Issued in CA
Practice address
571 Stanislaus St
Suite F
Angels Camp, CA 95221-0637
Phone
(209) 736-0956
Fax
(209) 736-0958
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 OPT132160 CA Primary

Addresses

Primary practice location

571 Stanislaus St
Suite F
Angels Camp, CA 95221-0637

Mailing address

PO Box 637
Altaville, CA 95221-0637
Phone (209) 736-0956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511001063 CA Practitioner - Physical Therapist in Private Practice 6800879529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theresa M Locke Physical Therapy IncGroup PAC ID 4284617994, 2 clinicians

Practice addresses (Care Compare)

571 Stanislaus Ave
Suite F
Angels Camp, CA 95222-9354
Phone (209) 736-0956

PO Box
637 571 Stanislaus Street Suite F
Angels Camp, CA 95221

PO Box
Suite 637
Angels Camp, CA 95221-0637

Merit-based Incentive Payment System (MIPS)

Final score
85.33 of 100Reported as individual
Quality
81.91
Improvement activities
40
Cost
75.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT132160CAMDPhysical Therapist
13216CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa M Locke Physical Therapy, Inc Physical Therapist CurrentSince Jan 1, 1999 Accepting new patients

Locations

571 Stanislaus Ave
Ste F
Angels Camp, CA 95222
Phone (209) 736-0956

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295750792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637",
            "city": "ALTAVILLE",
            "state": "CA",
            "postal_code": "952210637",
            "telephone_number": "209-736-0956",
            "fax_number": "209-736-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 STANISLAUS ST",
            "address_2": "SUITE F",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952210637",
            "telephone_number": "209-736-0956",
            "fax_number": "209-736-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "OPT132160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angels Camp, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.