Active NPI
Charles E. Bragunier, M.P.T.
- Physical Therapist
- Santee, CA
National Provider Identifier
1407804701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 9830 Prospect Ave
Ste. a
Santee, CA 92071-4375 - Phone
- (619) 448-4860
- Fax
- (619) 448-1639
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
9830 Prospect Ave
Ste. a
Santee, CA 92071-4375
Mailing address
600 S Andreasen Dr
Ste. C
Escondido, CA 92029-1917
Phone (760) 591-7750
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Barbara Jean Boutelle Carlsbad Physical Therapy | Physical Therapist | Past | Accepting new patients |
| Barbara Jean Boutelle Carlsbad Physical Therapy | Physical Therapist | Past | Accepting new patients |
Locations
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Physical Therapist
- Oceanside, CA
- NPI 1255007050
-
- Physical Therapist
- San Diego, CA
- NPI 1699723098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1407804701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S ANDREASEN DR",
"address_2": "STE. C",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920291917",
"telephone_number": "760-591-7750",
"fax_number": "760-294-9813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9830 PROSPECT AVE",
"address_2": "STE. A",
"city": "SANTEE",
"state": "CA",
"postal_code": "920714375",
"telephone_number": "619-448-4860",
"fax_number": "619-448-1639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGUNIER",
"first_name": "CHARLES",
"middle_name": "E.",
"name_prefix": "Mr.",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.