Robert P Eter Yarris, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6423 Issued in CA

Practice address

5480 Marengo Ave
La Mesa, CA 91942-2408

Phone

(619) 660-6687

Fax

(619) 660-1497

NPI assigned

Sep 21, 2008

Last updated

Nov 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Bob Peter Yarris Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1568612018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 MARENGO AVE.",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426932",
            "telephone_number": "619-660-6687",
            "fax_number": "619-660-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 MARENGO AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422408",
            "telephone_number": "619-660-6687",
            "fax_number": "619-660-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARRIS",
        "first_name": "ROBERT",
        "middle_name": "P ETER",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-21",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOB",
            "last_name": "YARRIS",
            "middle_name": "PETER",
            "prefix": "MR.",
            "credential": "PHYSICAL THERAPIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.