Organization Active NPI

Parkway Physical Therapy, PC

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1376214486
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PARKWAY PHYSICAL THERAPY, PC
Practice address
800 Howe Ave Ste 400
Sacramento, CA 95825-3913
Phone
(760) 470-3902
NPI assigned
Sep 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Ian Anderson Folsom, DPTNPI 1497188817
Title
Owner
Phone
(760) 470-3902

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

800 Howe Ave Ste 400
Sacramento, CA 95825-3913

Mailing address

4040 Berrendo Dr
Sacramento, CA 95864-3023
Phone (760) 470-3902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220126001868 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577955426 Receives reassigned benefits from 1 practitioner
Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory

Locations

800 Howe Ave
Ste 400
Sacramento, CA 95825
Phone (760) 470-3902

Practitioners & affiliated clinicians

Practitioners 1

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": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1376214486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BERRENDO DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643023",
            "telephone_number": "760-470-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWE AVE STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253913",
            "telephone_number": "760-470-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "FOLSOM",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "ANDERSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-470-3902",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.