NPIMap

Organization Active NPI

Marin Sport and Spine Physical Therapy

  • Orthopedic Physical Therapist
  • Kentfield, CA
National Provider Identifier
1487800942
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
MARIN SPORT AND SPINE PHYSICAL THERAPY
Practice address
810 College Ave
Suite 6
Kentfield, CA 94904-2532
Phone
(415) 614-0590
NPI assigned
Aug 14, 2008
Last updated
Aug 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN FRANCISCO SPORT AND SPINE PHYSICAL THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Authorized official

Name
Mr. Rich Waldron, PT
Title
Operations Manager
Phone
(415) 614-0590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

810 College Ave
Suite 6
Kentfield, CA 94904-2532

Mailing address

3727 Buchanan St
Suite 206
San Francisco, CA 94123-5410
Phone (415) 614-0590

National Provider Directory

National Provider Directory
Part of
San Francisco Sport Spine

Locations

810 College Ave
Ste 6
Kentfield, CA 94904
Phone (415) 413-4711

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1487800942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 BUCHANAN ST",
            "address_2": "SUITE 206",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941235410",
            "telephone_number": "415-614-0590",
            "fax_number": "415-593-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 COLLEGE AVE",
            "address_2": "SUITE 6",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949042532",
            "telephone_number": "415-614-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN SPORT AND SPINE PHYSICAL THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN FRANCISCO SPORT AND SPINE PHYSICAL THERAPY",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "415-614-0590",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.