Individual provider Active NPI

Charles T Spina, PT,JSCC,CEAS

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1386858959
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15431 Issued in CA
Practice address
7005 N Maple Ave
Suite 104
Fresno, CA 93720-8009
Phone
(559) 325-3503
Fax
(559) 325-3504
NPI assigned
May 10, 2007
Last updated
Apr 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT15431 CA Primary
Ergonomics Physical Therapist 2251E1200X

Addresses

Primary practice location

7005 N Maple Ave
Suite 104
Fresno, CA 93720-8009

Mailing address

6596 N Raisina Ave
Fresno, CA 93710-3945
Phone (916) 214-3941

Other identifiers 1

IdentifierTypeStateIssuer
CK761UOtherCAMEDICARE PTAN

Other names 1

  • Chuck Spina Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT15431CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand to Shoulder Rehab, Inc. Physical Therapist CurrentSince Apr 8, 2013 Accepting new patients
El Dorado Physical Therapy, Inc Physical Therapist PastSince Jan 1, 2010 Accepting new patients
El Dorado Physical Therapy & Associates Physical Therapist PastSince Jun 1, 2004 Accepting new patients
Newcastle Physical Therapy, Inc. Physical Therapist PastSince Dec 1, 1999 Accepting new patients
Sacramento Spine & Physical Therapy Inc. Physical Therapist Past Accepting new patients
Sacramento Spine & Physical Therapy Inc. Past Accepting new patients

Locations

7005 N Maple Ave
Ste 104
Fresno, CA 93720
Phone (559) 222-8785

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1386858959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6596 N RAISINA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937103945",
            "telephone_number": "916-214-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 N MAPLE AVE",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208009",
            "telephone_number": "559-325-3503",
            "fax_number": "559-325-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINA",
        "first_name": "CHARLES",
        "middle_name": "T",
        "credential": "PT,JSCC,CEAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15431",
            "primary": true
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CK761U",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "SPINA",
            "credential": "PT,JSCC,CEAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.