Marina Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

OPT281510 Issued in CA

Legal business name

MARINA PHYSICAL THERAPY, INC

Practice address

292 Reservation Rd
Marina, CA 93933-3110

Phone

(831) 883-8542

Fax

(831) 883-8526

NPI assigned

Jul 23, 2008

Last updated

Jul 31, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William F Manchester, DPTNPI 1346352713

Title

President

Phone

(831) 883-8542

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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.

• William Frederick Manchester, DPT

  • Physical Therapist
  • Marina, CA
  • NPI 1346352713
  Medicare reassignment NPD Authorized official
• Brenton Mikito Micah Kanno

  • Physical Therapist
  • Marina, CA
  • NPI 1619546439
  Medicare reassignment NPD

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1528223013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 RESERVATION RD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333110",
            "telephone_number": "831-883-8542",
            "fax_number": "831-883-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 RESERVATION RD",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939333110",
            "telephone_number": "831-883-8542",
            "fax_number": "831-883-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "MANCHESTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-883-8542",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "OPT281510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madigan Army Medical Center (Gourley VA DoD Clinic)
• William Frederick Manchester, DPT
• Dezirae Marie Manriquez
• Marina Doctors on Duty
• Marina Optometric Center Inc
• Marseille Dialysis, LLC (Marina Dialysis)
• Holly Martin
• Maria Martinez-Navarro
• Alet Martinez
• Emely Annett Martinez, BCBA

• Physical Therapy Clinic/Center in Marina, CA
• Providers in Marina, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.