Individual provider Active NPI

Camryn Elise Earley, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1457238099
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308478 Issued in CA
Practice address
5190 Governor Dr Ste 107
San Diego, CA 92122-2848
Phone
(858) 452-0282
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 308478 CA Primary

Addresses

Primary practice location

5190 Governor Dr Ste 107
San Diego, CA 92122-2848

Mailing address

14065 Mango Dr Apt C
Del Mar, CA 92014-4915
Phone (949) 370-8470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923002479 CA Practitioner - Physical Therapist in Private Practice 7012412943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FunctionsmartGroup PAC ID 5597825380, 8 clinicians

Practice addresses (Care Compare)

5190 Governor Dr
Suite 107
San Diego, CA 92122-2848
Phone (858) 452-0282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functionsmart Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients

Locations

5190 Governor Dr
Ste 107
San Diego, CA 92122
Phone (858) 452-0282

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": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1457238099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14065 MANGO DR APT C",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920144915",
            "telephone_number": "949-370-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222848",
            "telephone_number": "858-452-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "CAMRYN",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.

Verify at the official NPI Registry.