NPIMap

Organization Active NPI

Elite Performance Sports and Physical Therapy, Inc.

  • Physical Therapist
  • Rocklin, CA
National Provider Identifier
1457756702
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28076 Issued in CA
Legal business name
ELITE PERFORMANCE SPORTS AND PHYSICAL THERAPY, INC.
Practice address
6526 Lonetree Blvd
Suite 200
Rocklin, CA 95765-5886
Phone
(916) 772-2909
Fax
(916) 772-2989
NPI assigned
Oct 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Mr. Chris J Gulbrandson, MPT
Title
Owner
Phone
(916) 765-5661

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT28076 CA Primary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X PT28076 CA

Addresses

Primary practice location

6526 Lonetree Blvd
Suite 200
Rocklin, CA 95765-5886

Mailing address

6526 Lonetree Blvd
Suite 200
Rocklin, CA 95765-5886
Phone (916) 772-2909

Other names 1

  • Elite Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

6526 Lonetree Blvd
Ste 200
Rocklin, CA 95765
Phone (916) 772-2909

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1457756702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6526 LONETREE BLVD",
            "address_2": "SUITE 200",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655886",
            "telephone_number": "916-772-2909",
            "fax_number": "916-772-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6526 LONETREE BLVD",
            "address_2": "SUITE 200",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655886",
            "telephone_number": "916-772-2909",
            "fax_number": "916-772-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PERFORMANCE SPORTS AND PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "GULBRANDSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-765-5661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28076",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT28076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.