Individual provider Active NPI

Wayne James Gilmour

  • Physical Therapist
  • Granada Hills, CA
National Provider Identifier
1396199675
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291304 Issued in CA
Practice address
10725 Zelzah Ave
Ste B
Granada Hills, CA 91344-4431
Phone
(818) 832-8383
NPI assigned
Apr 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291304 CA Primary

Addresses

Primary practice location

10725 Zelzah Ave
Ste B
Granada Hills, CA 91344-4431

Mailing address

19510 Ventura Blvd
Ste 106
Tarzana, CA 91356-2974
Phone (661) 254-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160525001502 CA Practitioner - Physical Therapist in Private Practice 4284923640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Evolution Physical Therapy IncGroup PAC ID 0244336964, 72 clinicians

Practice addresses (Care Compare)

11825 Major St
Suite 107
Culver City, CA 90230-6356
Phone (310) 915-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
291304CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Next Phase Medical PC CurrentSince Sep 28, 2025 Accepting new patients
Evolution Physical Therapy, Inc Physical Therapist CurrentSince Jul 10, 2017 Accepting new patients
All Star Physical Therapy Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients

Locations

10725 Zelzah Ave
#B
Granada Hills, CA 91344
Phone (818) 400-0304

11825 Major St
Ste 107
Los Angeles, CA 90230
Phone (310) 915-6100

322 Culver Blvd
Playa del Rey, CA 90293
Phone (310) 461-8712

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1396199675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 VENTURA BLVD",
            "address_2": "STE 106",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562974",
            "telephone_number": "661-254-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10725 ZELZAH AVE",
            "address_2": "STE B",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444431",
            "telephone_number": "818-832-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMOUR",
        "first_name": "WAYNE",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.