NPIMap

Organization Active NPI

Redwood Pediatric Therapy Associates Inc

  • Pediatric Physical Therapist
  • Santa Rosa, CA
National Provider Identifier
1497048979
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
REDWOOD PEDIATRIC THERAPY ASSOCIATES INC
Practice address
340 Tesconi Cir
Suite C
Santa Rosa, CA 95401-4676
Phone
(707) 546-9160
Fax
(707) 546-1338
NPI assigned
May 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Ms. Karen Smith, OTR/L
Title
President
Phone
(704) 546-9160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X Primary

Addresses

Primary practice location

340 Tesconi Cir
Suite C
Santa Rosa, CA 95401-4676

Mailing address

340 Tesconi Cir
Suite C
Santa Rosa, CA 95401-4676
Phone (707) 546-9160

National Provider Directory

National Provider Directory
Tax ID family
Redwood Pediatric Therapy Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

340 Tesconi Cir
Ste C
Santa Rosa, CA 95401
Phone (707) 546-9160

Practitioners & affiliated clinicians

Practitioners 12

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": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1497048979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 TESCONI CIR",
            "address_2": "SUITE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014676",
            "telephone_number": "707-546-9160",
            "fax_number": "707-546-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 TESCONI CIR",
            "address_2": "SUITE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014676",
            "telephone_number": "707-546-9160",
            "fax_number": "707-546-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD PEDIATRIC THERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-546-9160",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.