Organization Active NPI

Auburn Orthopedic & Sports Physical

  • Physical Therapist
  • Auburn, CA
National Provider Identifier
1316291503
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AUBURN ORTHOPEDIC & SPORTS PHYSICAL
Practice address
11879 Kemper Rd.
Suite 4
Auburn, CA 95603
Phone
(530) 885-3940
Fax
(530) 885-3984
NPI assigned
Nov 9, 2012
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AUBURN ORTHOPEDIC & SPORTS PHYSICAL THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Ronald S Smith, PT, DPTNPI 1548252174
Title
Owner
Phone
(530) 885-3940

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 Therapist 225100000X Primary

Addresses

Primary practice location

11879 Kemper Rd.
Suite 4
Auburn, CA 95603

Mailing address

11879 Kemper Rd Ste 4
Auburn, CA 95603-9021
Phone (530) 885-3940

Other practice location 1

565 Brunswick Rd Ste 4
Grass Valley, CA 95945-9529
Phone (530) 273-4152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121212000465 CA Part B Supplier - Clinic/Group Practice 9234381583 Receives reassigned benefits from 5 practitioners
Practice locations: Auburn, CA; Grass Valley, CA

National Provider Directory

National Provider Directory
Part of
Auburn Orthopedic Sports Physical

Practitioners & affiliated clinicians

Practitioners 5

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": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1316291503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11879 KEMPER RD STE 4",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039021",
            "telephone_number": "530-885-3940",
            "fax_number": "530-885-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11879 KEMPER RD.",
            "address_2": "SUITE 4",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-885-3940",
            "fax_number": "530-885-3984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Brunswick Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Grass Valley",
            "state": "CA",
            "postal_code": "959459529",
            "country_code": "US",
            "telephone_number": "530-273-4152",
            "fax_number": "530-273-4153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUBURN ORTHOPEDIC & SPORTS PHYSICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUBURN ORTHOPEDIC & SPORTS PHYSICAL THERAPY",
        "enumeration_date": "2012-11-09",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-885-3940",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.