NPIMap

Organization Active NPI

Folsom Physical Therapy and Training Center

  • Orthopedic Physical Therapist
  • Folsom, CA
National Provider Identifier
1497788202
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
0603009 Issued in CA
Legal business name
FOLSOM PHYSICAL THERAPY AND TRAINING CENTER
Practice address
115 Natoma St
Folsom, CA 95630-2615
Phone
(916) 355-8500
Fax
(916) 355-8196
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Mr. Timothy Eugene McGonigle, P.T.
Title
Physical Therapist, Co-Owner
Phone
(916) 355-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X 0603009 CA Primary

Addresses

Primary practice location

115 Natoma St
Folsom, CA 95630-2615

Mailing address

115 Natoma St
Folsom, CA 95630-2615
Phone (916) 355-8500

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ61124ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000146 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6800837238 Receives reassigned benefits from 7 practitioners
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Locations

115 Natoma St
Folsom, CA 95630
Phone (916) 355-8500

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1497788202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302615",
            "telephone_number": "916-355-8500",
            "fax_number": "916-355-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302615",
            "telephone_number": "916-355-8500",
            "fax_number": "916-355-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOLSOM PHYSICAL THERAPY AND TRAINING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "MCGONIGLE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, CO-OWNER",
        "authorized_official_telephone_number": "916-355-8500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "0603009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ61124Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.