Active NPI
Carol A. Antovich, P.T.
- Physical Therapist
- Elk Grove, CA
National Provider Identifier
1306850649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 13470
- Practice address
- 9156 Elk Grove Blvd
Elk Grove, CA 95624-2013 - Phone
- (916) 684-4100
- Fax
- (916) 684-5299
- NPI assigned
- Jul 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 13470 | CA | Primary |
Addresses
Primary practice location
9156 Elk Grove Blvd
Elk Grove, CA 95624-2013
Mailing address
9156 Elk Grove Blvd
Elk Grove, CA 95624-2013
Phone (916) 684-4100
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 13470 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Antovich Chiropractic Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinic/Center
- Elk Grove, CA
- NPI 1740547082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1306850649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9156 ELK GROVE BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956242013",
"telephone_number": "916-684-4100",
"fax_number": "916-684-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9156 ELK GROVE BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956242013",
"telephone_number": "916-684-4100",
"fax_number": "916-684-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOVICH",
"first_name": "CAROL",
"middle_name": "A.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-29",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 13470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.