Community Physical Therapy Ctr Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5788 Issued in CA

Legal business name

COMMUNITY PHYSICAL THERAPY CTR INC

Practice address

725 S Long Beach Blvd
Compton, CA 90221-4028

Phone

(310) 631-8703

Fax

(310) 763-0400

NPI assigned

Sep 12, 2005

Last updated

Nov 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Jackson, PTNPI 1235306143

Title

Administrator

Phone

(310) 631-8703

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Joseph Jackson, R.P.T.

  • Physical Therapist
  • Gardena, CA
  • NPI 1235306143
  Authorized official Same address or phone

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1316932825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S LONG BEACH BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902214028",
            "telephone_number": "310-631-8703",
            "fax_number": "310-763-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S LONG BEACH BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902214028",
            "telephone_number": "310-631-8703",
            "fax_number": "310-763-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHYSICAL THERAPY CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-631-8703",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT5788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CW140A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Compton

• Physical Therapist in Compton, CA
• Providers in Compton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.