Organization Active NPI

Coastal Therapy Inc

  • Physical Therapist
  • Arcadia, CA
National Provider Identifier
1396300216
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COASTAL THERAPY INC
Practice address
123 E Duarte Rd
Arcadia, CA 91006-3935
Phone
(626) 461-5350
Fax
(626) 462-9695
NPI assigned
May 6, 2019
Last updated
May 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Kenneth E H Richards Jr., PT
Title
President
Phone
(626) 461-5350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

123 E Duarte Rd
Arcadia, CA 91006-3935

Mailing address

123 E Duarte Rd
Arcadia, CA 91006-3935
Phone (626) 461-5350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190718000593 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6002141637 Receives reassigned benefits from 1 practitioner
Practice locations: Arcadia, CA; Rosemead, CA

National Provider Directory

National Provider Directory

Locations

123 E Duarte Rd
Arcadia, CA 91006
Phone (626) 461-5337

2630 San Gabriel Blvd
Ste 103
Rosemead, CA 91770
Phone (562) 618-7708

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1396300216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E DUARTE RD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063935",
            "telephone_number": "626-461-5350",
            "fax_number": "626-462-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E DUARTE RD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063935",
            "telephone_number": "626-461-5350",
            "fax_number": "626-462-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-461-5350",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.