NPIMap

Organization Active NPI

Athletic Physical Therapy, Inc

  • Physical Therapist
  • Oxnard, CA
National Provider Identifier
1487966719
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATHLETIC PHYSICAL THERAPY, INC
Practice address
1751 Lombard St
Suite a
Oxnard, CA 93030-8266
Phone
(805) 981-2289
Fax
(805) 981-7979
NPI assigned
Jul 1, 2010
Last updated
Jul 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Mr. Stephen W. Clark, DPT, PTNPI 1366567307
Title
President
Phone
(818) 340-2002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1751 Lombard St
Suite a
Oxnard, CA 93030-8266

Mailing address

30877 Thousand Oaks Blvd
Westlake Village, CA 91362-4039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041202000150 CA Part B Supplier - Clinic/Group Practice 6507821436 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Simi Valley, CA; Westlake Village, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12424 Wilshire Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 826-2977

1751 Lombard St
#A
Oxnard, CA 93030
Phone (805) 981-9111

1464 Madera Rd
Ste G
Simi Valley, CA 93065
Phone (805) 306-1622

2230 Lynn Rd
Ste 250
Thousand Oaks, CA 91360
Phone (805) 379-1748

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1487966719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30877 THOUSAND OAKS BLVD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 LOMBARD ST",
            "address_2": "SUITE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930308266",
            "telephone_number": "805-981-2289",
            "fax_number": "805-981-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-340-2002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.