NPIMap

Organization Active NPI

Folsom Physical Therapy & Training Center Inc

  • Physical Therapy Clinic/Center
  • Folsom, CA
National Provider Identifier
1376379248
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FOLSOM PHYSICAL THERAPY & TRAINING CENTER INC
Practice address
115 Natoma St
Folsom, CA 95630-2615
Phone
(916) 355-8500
NPI assigned
Sep 9, 2024
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Michael J Moore, RPTNPI 1104900620
Title
President
Phone
(916) 355-8500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

115 Natoma St
Folsom, CA 95630-2615

Mailing address

115 Natoma St
Folsom, CA 95630-2615
Phone (916) 355-8500

Other names 1

  • Folsom Physical Therapy & Training Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241218002375 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9032646880 Receives reassigned benefits from 9 practitioners
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Locations

111 Woodmere Rd
Ste 270
Folsom, CA 95630

115 Natoma St
Folsom, CA 95630
Phone (916) 355-8500

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1376379248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302615",
            "telephone_number": "916-355-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302615",
            "telephone_number": "916-355-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOLSOM PHYSICAL THERAPY & TRAINING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-355-8500",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Folsom Physical Therapy & Training Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.