NPIMap

Organization Active NPI

Forgeron Physical Therapy

  • Physical Therapist
  • Palm Springs, CA
National Provider Identifier
1366449118
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10849 Issued in CA
Legal business name
FORGERON PHYSICAL THERAPY
Practice address
555 E Tachevah Dr
1 East #201
Palm Springs, CA 92262-5750
Phone
(760) 778-7150
Fax
(760) 778-7180
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Mr. Jay A Forgeron, PT
Title
Owner
Phone
(760) 778-7150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT10849 CA Primary

Addresses

Primary practice location

555 E Tachevah Dr
1 East #201
Palm Springs, CA 92262-5750

Mailing address

555 E Tachevah Dr
1 East #201
Palm Springs, CA 92262-5750
Phone (760) 778-7150

Other identifiers 6

IdentifierTypeStateIssuer
BS296ZOtherCAPTAN
AV430YOtherCAPTAN
DF558ZOtherCAPTAN
35396OtherCAPHYSICAL THERAPY BOARD OF CALIFORNIA
PT26534OtherCAPHYSICAL THERAPY LICENSE
PT35038OtherCAPHYSICAL THERAPY BOARD OF CALIFORNIA

National Provider Directory

National Provider Directory
Tax ID family
Forgeron Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

555 E Tachevah Dr
Ste 1E201
Palm Springs, CA 92262
Phone (760) 299-6487

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1366449118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR",
            "address_2": "1 EAST #201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625750",
            "telephone_number": "760-778-7150",
            "fax_number": "760-778-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR",
            "address_2": "1 EAST #201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625750",
            "telephone_number": "760-778-7150",
            "fax_number": "760-778-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORGERON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "FORGERON",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-778-7150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT10849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BS296Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "AV430Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DF558Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "35396",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT26534",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "PT35038",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.