Active NPI
Justin Knapp-Wood, PT, DPT, CSCS
- Physical Therapist
- Berkeley, CA
National Provider Identifier
1417235516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38087
- Practice address
- 1803 Bonita Ave
Berkeley, CA 94709-2117 - Phone
- (786) 488-5908
- NPI assigned
- Jul 25, 2011
- 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 | 38087 | CA | Primary |
Addresses
Primary practice location
1803 Bonita Ave
Berkeley, CA 94709-2117
Mailing address
2491 Purdue Ave Apt 116
Los Angeles, CA 90064-5118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Miami, LM Miller School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15250 Ventura Blvd
Suite 300
Sherman Oaks, CA 91403-3214
Phone (818) 990-0267
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38087 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bechtel Physical Therapy Inc | Physical Therapist | Current | Accepting new patients |
Locations
15250 Ventura Blvd
Ste 300
Sherman Oaks, CA 91403
Phone (818) 990-0267
Organizations & group practices 1
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.
-
- Orthopedic Physical Therapist
- Sherman Oaks, CA
- NPI 1447953674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1417235516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2491 PURDUE AVE APT 116",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 BONITA AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947092117",
"telephone_number": "786-488-5908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNAPP-WOOD",
"first_name": "JUSTIN",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-25",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "38087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.