NPIMap

Organization Active NPI

Sports Medicine and Rehab Therapy, Inc.

  • Physical Therapist
  • Bishop, CA
National Provider Identifier
1528147907
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00PT78460 Issued in CA
Legal business name
SPORTS MEDICINE AND REHAB THERAPY, INC.
Practice address
152 Pioneer LN
Suite D
Bishop, CA 93514-2563
Phone
(760) 873-8220
Fax
(760) 873-4443
NPI assigned
Nov 4, 2006
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Ms. Patricia L. Gardner, P.T.
Title
President
Phone
(760) 873-8220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00PT78460 CA Primary
Orthopedic Physical Therapist 2251X0800X 0PT253460 CA

Addresses

Primary practice location

152 Pioneer LN
Suite D
Bishop, CA 93514-2563

Mailing address

152 Pioneer LN
Suite D
Bishop, CA 93514-2563
Phone (760) 873-8220

Other names 1

  • SMART,Inc. Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1528147907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "SUITE D",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-873-8220",
            "fax_number": "760-873-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "SUITE D",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-873-8220",
            "fax_number": "760-873-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE AND REHAB THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-04",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-873-8220",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "00PT78460",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "0PT253460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMART,Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.