Lemuel C & Elmezen Martin

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT11399 Issued in CA

Legal business name

LEMUEL C & ELMEZEN MARTIN

Doing business as

Quail Run Physical Therapy

Practice address

422 Lakeport Blvd
Lakeport, CA 95453-5404

Phone

(707) 263-6845

Fax

(707) 263-6451

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Lemuel Campomanes Martin, PTNPI 1083622039

Title

Physical Therapist Owner

Phone

(707) 263-6845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Quail Run Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Lemuel Campomanes Martin, PT

  • Physical Therapist
  • Lakeport, CA
  • NPI 1083622039
  Medicare reassignment NPD Authorized official
• Ildefonso Timple Campomanes III, P.T.

  • Orthopedic Physical Therapist
  • Bakersfield, CA
  • NPI 1588877666

  Physical Therapy

  NPD (past)
• Matthew J. Garrean, P.T.

  • Physical Therapist
  • Lakeport, CA
  • NPI 1184788531
  NPD (past)
• Elmezen Oliverio Martin, RDHAP

  • Dental Hygienist
  • Lakeport, CA
  • NPI 1033431630
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1477614741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531560",
            "telephone_number": "707-263-6845",
            "fax_number": "707-263-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 LAKEPORT BLVD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535404",
            "telephone_number": "707-263-6845",
            "fax_number": "707-263-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEMUEL C & ELMEZEN MARTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "LEMUEL",
        "authorized_official_middle_name": "CAMPOMANES",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST OWNER",
        "authorized_official_telephone_number": "707-263-6845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ06870Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quail Run Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Kristine Lane
• Tanya Louise Lane, MHRS
• Donald R. Lasher, O.D.
• Simone Latham
• Jai Goo Lee, DDS
• Ivette Lepe
• Peter Joseph Leresche
• Levi S.Palmer, DDS, Inc.
• Patricia Ann Levine, RN
• Daniel Gene Lewis, M.D.

• Physical Therapist in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.