NPIMap

Organization Active NPI

RJ Physical Therapy Group Inc

  • Physical Therapist
  • Inglewood, CA
National Provider Identifier
1306290085
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22486 Issued in CA
Legal business name
RJ PHYSICAL THERAPY GROUP INC
Practice address
575 E Hardy St Ste 105
Inglewood, CA 90301-4040
Phone
(310) 412-0100
Fax
(310) 412-0110
NPI assigned
Apr 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Ronnie JohnsonNPI 1487754883
Title
Ceo
Phone
(310) 779-8901

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT22486 CA Primary

Addresses

Primary practice location

575 E Hardy St Ste 105
Inglewood, CA 90301-4040

Mailing address

PO Box 452464
Los Angeles, CA 90045-8533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170124002192 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234411463 Receives reassigned benefits from 7 practitioners
Practice locations: Inglewood, CA

National Provider Directory

National Provider Directory

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": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1306290085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452464",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900458533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 105",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014040",
            "telephone_number": "310-412-0100",
            "fax_number": "310-412-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RJ PHYSICAL THERAPY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-779-8901"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.