Thomas Russell, PT, DPT

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

292213 Issued in CA

Practice address

380 Stevens Ave
Suite 314
Solana Beach, CA 92075-2063

Phone

(858) 755-5200

Fax

(858) 755-5201

NPI assigned

Jul 27, 2016

Last updated

Nov 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1316490113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 STEVENS AVE",
            "address_2": "SUITE 314",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752063",
            "telephone_number": "858-755-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 STEVENS AVE",
            "address_2": "SUITE 314",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752063",
            "telephone_number": "858-755-5200",
            "fax_number": "858-755-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THOMAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "292213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• Physical Rehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.