Individual provider Active NPI

Rene Andre Maillard, P.T.

  • Physical Therapist
  • Napa, CA
National Provider Identifier
1306929484
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24674 Issued in CA
Practice address
3421 Villa LN Ste a
Napa, CA 94558-3056
Phone
(707) 257-4089
Fax
(707) 257-4188
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 PT24674 CA Primary

Addresses

Primary practice location

3421 Villa LN Ste a
Napa, CA 94558-3056

Mailing address

1685 E Napa St
Sonoma, CA 95476-3834
Phone (707) 721-6405

Other identifiers 2

IdentifierTypeStateIssuer
P00160372OtherCARAIL ROAD MEDICARE
0PT246740OtherCABLUE SHIELD

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

LicenseStateTypeSpecialty
PT24674CAMDPhysical Therapist
24674CAMDDental Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Tokheim Corbett Physical Therapy Physical Therapist PastSince Sep 1, 2004 Accepting new patients
Motus Physical Therapy and Performance Inc Physical Therapist PastSince Jan 1, 2018 Accepting new patients
TSH Inc. Physical Therapist PastSince Dec 17, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1306929484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 E NAPA ST",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954763834",
            "telephone_number": "707-721-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 VILLA LN STE A",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583056",
            "telephone_number": "707-257-4089",
            "fax_number": "707-257-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLARD",
        "first_name": "RENE",
        "middle_name": "ANDRE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00160372",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0PT246740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.