NPIMap

Organization Active NPI

TKL Industries

Doing business as OrthoSport Physical Therapy

  • Orthopedic Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1417995184
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT16450 Issued in CA
Legal business name
TKL INDUSTRIES
Doing business as
OrthoSport Physical Therapy
Practice address
20101 SW Birch St
Ste 140
Newport Beach, CA 92660-1748
Phone
(949) 721-9400
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Mr. Michael Patrick Taylor, P.T.
Title
President
Phone
(949) 721-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X PT16450 CA Primary

Addresses

Primary practice location

20101 SW Birch St
Ste 140
Newport Beach, CA 92660-1748

Mailing address

20101 SW Birch St
Ste 140
Newport Beach, CA 92660-1748
Phone (949) 721-9400

Other names 1

  • OrthoSport Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

20101 SW Birch St
Ste 140
Newport Beach, CA 92660
Phone (949) 721-7400

Practitioners & affiliated clinicians

Practitioners 3

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1417995184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20101 SW BIRCH ST",
            "address_2": "STE 140",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601748",
            "telephone_number": "949-721-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20101 SW BIRCH ST",
            "address_2": "STE 140",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601748",
            "telephone_number": "949-721-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TKL INDUSTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-721-9400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT16450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoSport Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.