Individual provider Active NPI

Mary E Hermes, M.S.P.T.

  • Physical Therapist
  • La Jolla, CA
National Provider Identifier
1518028547
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24707 Issued in CA
Practice address
7629 Girard Ave
201
La Jolla, CA 92037-0076
Phone
(773) 495-6522
Fax
(858) 255-8364
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-011690 IL
Physical Therapist 225100000X 24707 CA Primary

Addresses

Primary practice location

7629 Girard Ave
201
La Jolla, CA 92037-0076

Mailing address

7629 Girard Ave
201
La Jolla, CA 92037-0076
Phone (773) 495-6522

Other identifiers 1

IdentifierTypeStateIssuer
20-5186080OtherILFEIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-011690ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jun 17, 2024 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Jun 17, 2024 Accepting new patients
Kids on the Go Physical Therapy Inc. Physical Therapist Past Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1518028547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 GIRARD AVE",
            "address_2": "201",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920370076",
            "telephone_number": "773-495-6522",
            "fax_number": "858-255-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 GIRARD AVE",
            "address_2": "201",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920370076",
            "telephone_number": "773-495-6522",
            "fax_number": "858-255-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMES",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-011690",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "20-5186080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.