Organization Active NPI

Gardena Physical Therapy Inc

  • Physical Therapist
  • Gardena, CA
National Provider Identifier
1447727235
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GARDENA PHYSICAL THERAPY INC
Practice address
1045 W Redondo Beach Blvd Ste 130
Gardena, CA 90247-4129
Phone
(310) 329-1444
NPI assigned
Oct 30, 2018
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Jamie McLachlan
Title
Director of Operations
Phone
(310) 329-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1045 W Redondo Beach Blvd Ste 130
Gardena, CA 90247-4129

Mailing address

1045 W Redondo Beach Blvd Ste 130
Gardena, CA 90247-4129
Phone (310) 329-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190520001570 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709129539 Receives reassigned benefits from 6 practitioners
Practice locations: Gardena, CA

National Provider Directory

National Provider Directory

Locations

1045 W Redondo Beach Blvd
Ste 120
Gardena, CA 90247

1045 W Redondo Beach Blvd
Ste 130
Gardena, CA 90247
Phone (310) 329-1444

Practitioners & affiliated clinicians

Practitioners 8

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": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1447727235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 W REDONDO BEACH BLVD STE 130",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474129",
            "telephone_number": "310-329-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W REDONDO BEACH BLVD STE 130",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474129",
            "telephone_number": "310-329-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENA PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2022-10-06",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "MCLACHLAN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "310-329-1444"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.