NPIMap

Organization Active NPI

California Sports Physical Therapy Centers, Inc.

  • Physical Therapist
  • Lancaster, CA
National Provider Identifier
1528040037
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.
Practice address
1306 W Avenue J
Suite 2
Lancaster, CA 93534
Phone
(661) 948-0186
Fax
(661) 945-5736
NPI assigned
Nov 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Mr. Jonathan Dockery
Title
Vice President of Revenue Cycle
Phone
(760) 602-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1306 W Avenue J
Suite 2
Lancaster, CA 93534

Mailing address

2000 Garden Rd
Monterey, CA 93940-5313
Phone (831) 375-1885

Other names 1

  • Valley Physical Therapy Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707001097 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618956889 Receives reassigned benefits from 63 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monterey, CA; Walnut Creek, CA; Tracy, CA; Stockton, CA; San Ramon, CA; Rocklin, CA; Manteca, CA; Lodi, CA…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1306 W Avenue J
#2
Lancaster, CA 93534
Phone (661) 948-0186

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1528040037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GARDEN RD",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405313",
            "telephone_number": "831-375-1885",
            "fax_number": "831-375-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 W AVENUE J",
            "address_2": "SUITE 2",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-948-0186",
            "fax_number": "661-945-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA SPORTS PHYSICAL THERAPY CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "DOCKERY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF REVENUE CYCLE",
        "authorized_official_telephone_number": "760-602-4105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Physical Therapy Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.