NPIMap

Organization Active NPI

Fitzpatrick Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Placerville, CA
National Provider Identifier
1295783900
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FITZPATRICK PHYSICAL THERAPY INC.
Practice address
1252 Broadway
Suite B
Placerville, CA 95667-5806
Phone
(530) 622-9410
Fax
(530) 622-9445
NPI assigned
May 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marian Claire Fitzpatrick, P.T.NPI 1659329456
Title
President
Phone
(530) 622-9410

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 Primary

Addresses

Primary practice location

1252 Broadway
Suite B
Placerville, CA 95667-5806

Mailing address

1252 Broadway
Suite B
Placerville, CA 95667-5806
Phone (530) 622-9410

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ64235ZOtherCABLUE SHIELD ID #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050131001003 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183674724 Receives reassigned benefits from 16 practitioners
Practice locations: Jackson, CA; Placerville, CA

National Provider Directory

National Provider Directory

Locations

12150 Industry Blvd
Ste 42
Jackson, CA 95642
Phone (209) 223-9410

1252 Broadway
Placerville, CA 95667
Phone (318) 680-8208

1252 Broadway
Ste B
Placerville, CA 95667
Phone (530) 622-9410

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295783900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 BROADWAY",
            "address_2": "SUITE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675806",
            "telephone_number": "530-622-9410",
            "fax_number": "530-622-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 BROADWAY",
            "address_2": "SUITE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675806",
            "telephone_number": "530-622-9410",
            "fax_number": "530-622-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZPATRICK PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-622-9410",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID #",
            "identifier": "ZZZ64235Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.