Individual provider Active NPI

Paul Joseph Feuerborn, P.T.

  • Orthopedic Physical Therapist
  • Ventura, CA
National Provider Identifier
1417928425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT10311 Issued in CA
Practice address
2895 Loma Vista Rd
Suite B
Ventura, CA 93003-1572
Phone
(805) 643-4093
Fax
(805) 643-8401
NPI assigned
Jan 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT10311 CA Primary

Addresses

Primary practice location

2895 Loma Vista Rd
Suite B
Ventura, CA 93003-1572

Mailing address

1225 Sunnycrest Ave
Ventura, CA 93003-1212
Phone (805) 642-3778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002497 CA Practitioner - Physical Therapist in Private Practice 8123283306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT10311CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Therapy Services, Inc Orthopedic CurrentSince Sep 1, 1986 Accepting new patients

Locations

400 E Santa Barbara St
Ste B
Santa Paula, CA 93060
Phone (805) 525-6402

5550 Telegraph Rd
Ste A
Ventura, CA 93003
Phone (805) 222-0136

2895 Loma Vista Rd
Ste B
Ventura, CA 93003
Phone (805) 320-7225

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417928425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 SUNNYCREST AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031212",
            "telephone_number": "805-642-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 LOMA VISTA RD",
            "address_2": "SUITE B",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031572",
            "telephone_number": "805-643-4093",
            "fax_number": "805-643-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEUERBORN",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT10311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.