Organization Active NPI

La Jolla Sol Ventures Inc

Doing business as Coast Physical Therapy and Sports Medicine

  • Orthopedic Physical Therapist
  • La Jolla, CA
National Provider Identifier
1447512983
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
30242 Issued in CA
Legal business name
LA JOLLA SOL VENTURES INC
Doing business as
Coast Physical Therapy and Sports Medicine
Practice address
8950 Villa la Jolla Dr Ste A125
La Jolla, CA 92037-1706
Phone
(858) 452-3502
Fax
(858) 452-3503
NPI assigned
Jun 11, 2012
Last updated
Oct 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Renee R Higgins
Title
Billing Manager
Phone
(858) 999-4211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 30242 CA Primary

Addresses

Primary practice location

8950 Villa la Jolla Dr Ste A125
La Jolla, CA 92037-1706

Mailing address

8950 Villa la Jolla Dr Ste A125
La Jolla, CA 92037-1706
Phone (858) 452-3502

Other names 1

  • Coast Physical Therapy and Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120821000225 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375790736 Receives reassigned benefits from 1 practitioner
Practice locations: La Jolla, CA

National Provider Directory

National Provider Directory

Locations

8950 Villa La Jolla Dr
Ste A125
La Jolla, CA 92037
Phone (858) 452-3502

8950 Villa La Jolla Dr
Ste B224
La Jolla, CA 92037
Phone (858) 452-3502

Practitioners & affiliated clinicians

Practitioners 12

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": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1447512983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE A125",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371706",
            "telephone_number": "858-452-3502",
            "fax_number": "858-452-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE A125",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371706",
            "telephone_number": "858-452-3502",
            "fax_number": "858-452-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA SOL VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "858-999-4211"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "30242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Physical Therapy and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coast Physical Therapy and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.