NPIMap

Organization Active NPI

Ponderosa Physical Therapy Corp.

Doing business as Ponderosa Physical Therapy

  • Physical Therapist
  • Grass Valley, CA
National Provider Identifier
1356966295
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PONDEROSA PHYSICAL THERAPY CORP.
Doing business as
Ponderosa Physical Therapy
Practice address
696 Whiting St
Grass Valley, CA 95945-7543
Phone
(530) 777-5605
NPI assigned
Jun 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Dr. Chelsea Elizabeth Lynch, PT, DPTNPI 1730467481
Title
Owner, PT
Phone
(530) 777-5605

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

696 Whiting St
Grass Valley, CA 95945-7543

Mailing address

15421 You Bet Rd
Grass Valley, CA 95945-8010
Phone (503) 867-7229

Other names 1

  • Ponderosa Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200720002120 CA Part B Supplier - Clinic/Group Practice 0547684839 Receives reassigned benefits from 10 practitioners
Practice locations: Grass Valley, CA

National Provider Directory

National Provider Directory

Locations

107 W Main St
Ste B
Grass Valley, CA 95945
Phone (503) 867-7229

696 Whiting St
Grass Valley, CA 95945
Phone (503) 867-7229

Practitioners & affiliated clinicians

Practitioners 12

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": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1356966295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15421 YOU BET RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458010",
            "telephone_number": "503-867-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 WHITING ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959457543",
            "telephone_number": "530-777-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA PHYSICAL THERAPY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "530-777-5605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponderosa Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ponderosa Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.