Active NPI
Shepardson Physical Therapy Corporation
- Physical Therapy Clinic/Center
- San Jose, CA
National Provider Identifier
1497593602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- SHEPARDSON PHYSICAL THERAPY CORPORATION
- Practice address
- 1314 Lincoln Ave Ste 1F
San Jose, CA 95125-3012 - Phone
- (831) 999-0880
- Fax
- (833) 435-3990
- NPI assigned
- Jul 20, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jason Oliver Shepardson, DPT, PT
- Title
- Doctor of Physical Therapy
- Phone
- (831) 999-0880
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
1314 Lincoln Ave Ste 1F
San Jose, CA 95125-3012
Mailing address
952 Kennedy Dr Apt B
Capitola, CA 95010-2372
Phone (831) 999-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240910002896 | CA | Part B Supplier - Clinic/Group Practice | 9032659636 |
Receives reassigned benefits from 8 practitioners Practice locations: San Jose, CA; Soquel, CA |
National Provider Directory
National Provider DirectoryLocations
1314 Lincoln Ave
Ste 1F
San Jose, CA 95125
Phone (831) 999-0880
4630 Soquel Dr
Ste 2
Soquel, CA 95073
Phone (831) 204-0095
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Soquel, CA
- NPI 1174283675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721433600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1497593602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "952 KENNEDY DR APT B",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102372",
"telephone_number": "831-999-0880",
"fax_number": "833-435-3990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 LINCOLN AVE STE 1F",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951253012",
"telephone_number": "831-999-0880",
"fax_number": "833-435-3990"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHEPARDSON PHYSICAL THERAPY CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2024-07-20",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A",
"authorized_official_last_name": "SHEPARDSON",
"authorized_official_first_name": "JASON",
"authorized_official_middle_name": "OLIVER",
"authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY",
"authorized_official_telephone_number": "831-999-0880",
"authorized_official_credential": "DPT, PT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.