Proactive Spine & Sports Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

39209 Issued in CA

Legal business name

PROACTIVE SPINE & SPORTS PHYSICAL THERAPY

Practice address

2620 Larkspur Lane
Suite T
Redding, CA 96002-1043

Phone

(530) 605-4422

Fax

(530) 722-4289

NPI assigned

May 9, 2013

Last updated

Dec 31, 2022By 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

Dr. Dale P. Little, DPTNPI 1588684500

Title

Owner/Ceo

Phone

(530) 605-4422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Dale P. Little, DPT

  • Physical Therapist
  • Redding, CA
  • NPI 1588684500
  Medicare reassignment Care Compare group NPD Authorized official
• Alice Hajdu, PT

  • Physical Therapist
  • Redding, CA
  • NPI 1417421702
  Medicare reassignment Care Compare group NPD
• Lisa M Giusty, DPT

  • Physical Therapist
  • Rochester Hills, MI
  • NPI 1649517152

  CA

  Medicare reassignment Care Compare group NPD
• Judy Lynn Mason, PT

  • Physical Therapist
  • Redding, CA
  • NPI 1295443497
  NPD

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672444800000",
    "number": "1598100109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 LARKSPUR LN STE T",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021043",
            "telephone_number": "530-605-4422",
            "fax_number": "530-722-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 LARKSPUR LANE",
            "address_2": "SUITE T",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021043",
            "telephone_number": "530-605-4422",
            "fax_number": "530-722-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE SPINE & SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2022-12-31",
        "certification_date": "2022-12-31",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "530-605-4422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "39209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Redding, CA
• Providers in Redding, 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 Dec 31, 2022; 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.