Vanderbilt Physical Therapy

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

0PT24958 Issued in CA

Legal business name

VANDERBILT PHYSICAL THERAPY

Practice address

107 S Harding Blvd
Roseville, CA 95678-3354

Phone

(916) 879-7867

Fax

(916) 435-4970

NPI assigned

Nov 5, 2006

Last updated

Aug 22, 2020By 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

John J Vanderbilt Jr., PTNPI 1679657985

Title

Chief Executive Officer

Phone

(916) 879-7867

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• John J. Vanderbilt Jr., MPT

  • Physical Therapist
  • Roseville, CA
  • NPI 1679657985
  Authorized official Same address or phone
• Courtney Nicole Powers, MOT, OTR/L, CHT

  • Hand Occupational Therapist
  • Roseville, CA
  • NPI 1598138711
  NPD (past)

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366521783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 KLAMATH DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655202",
            "telephone_number": "916-879-7867",
            "fax_number": "916-435-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S HARDING BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956783354",
            "telephone_number": "916-879-7867",
            "fax_number": "916-435-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDERBILT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDERBILT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-879-7867",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "0PT24958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Clark Van Wert, M.S. MFTI
• Lauren Narvaez Van Winkle, O.D.
• Phuong Van-Khieu
• Kelsey Vandenborn, PMHNP
• Monique A Vandenbos, M.A., LMFT
• John J. Vanderbilt Jr., MPT
• McKenna Vanderhaegen
• Penny Robillard Vandestreek, D.O.
• Frankie Vang
• Iaoo Vang, LCSW

• Orthopedic Physical Therapist in Roseville, CA
• Providers in Roseville, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.