Tactical Athlete Performance & Physical Therapy Specialists, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

TACTICAL ATHLETE PERFORMANCE & PHYSICAL THERAPY SPECIALISTS, INC.

Practice address

8800 Shortline LN
Elk Grove, CA 95624-9470

Phone

(916) 717-9406

NPI assigned

Mar 18, 2024

Organization subpart

No

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

Authorized official

Name

Nicholas Detrick, PTNPI 1306360797

Title

Owner

Phone

(916) 717-9406

Specialties & licenses 1

Addresses

Practitioners 1

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

• Nicholas A Detrick, DPT

  • Physical Therapist
  • Jbsa Lackland, TX
  • NPI 1306360797
  NPD Authorized official

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1487413787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 SHORTLINE LN",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249470",
            "telephone_number": "916-717-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 SHORTLINE LN",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249470",
            "telephone_number": "916-717-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACTICAL ATHLETE PERFORMANCE & PHYSICAL THERAPY SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-717-9406",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Szeto
• Eric Szymonski, OT
• Linh Ta
• Roman Richard Tabayoyon
• Bless Tabel
• Naqshe Zeb Tahirhkheli
• Noor Tahirkheli
• Tai Healthcare LLC
• Chueh Chiao Tai, L. AC,
• Chun K Tai, PHARM D

• Physical Therapy Clinic/Center in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.