Corey Rogers
Individual provider Active NPI Physical Therapist · Ripon, CA
NPI 1508728783 · NPPES record last updated Nov 26, 2025
Key facts
- NPI
- 1508728783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 309351 (CA)
- Practice address
- 1222 W Colony Rd Ste 130
Ripon, CA 95366-9482 - Phone
- (209) 624-1288
- NPI assigned
- Nov 26, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Golden Bear Physical Therapy Sports Injury Center Inc
Practice addresses (Care Compare)
1222 W Colony Rd
Suite 130
Ripon, CA 95366-9482
Phone (209) 624-1288
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260227003784 | CA | Practitioner - Physical Therapist in Private Practice | 7719468602 |
Reassigns benefits to 1 organization Practice locations: Ripon, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309351 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Bear Physical Therapy Sports Injury Center, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 309351 | CA | Yes |
Addresses
Primary practice location
1222 W Colony Rd Ste 130
Ripon, CA 95366-9482
Mailing address
1222 W Colony Rd Ste 130
Ripon, CA 95366-9482
Phone (209) 624-1288
NPI Registry JSON
{
"created_epoch": "1764115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764115200000",
"number": "1508728783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 W COLONY RD STE 130",
"city": "RIPON",
"state": "CA",
"postal_code": "953669482",
"telephone_number": "209-624-1288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 W COLONY RD STE 130",
"city": "RIPON",
"state": "CA",
"postal_code": "953669482",
"telephone_number": "209-624-1288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "COREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-26",
"last_updated": "2025-11-26",
"certification_date": "2025-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "309351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripon, CA
- Ripon Family Physicians
- Ripon Primary & Urgent Care Center
- Ripon Primary & Urgent Care Center a Medical Corporation
- Ripon Unified School District
- Rachel Rodriguez
- Jessica Lynn Ronchetti
- Azsha Marie Samando
- Lawrence Joseph Sarkis
- Laura Marie Sauers
- Lana Jo Scott
All providers in Ripon, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.