Active NPI
Thomas Fitzgerald, PT
- Physical Therapist
- Agoura Hills, CA
National Provider Identifier
1609501352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 295630
- Practice address
- 29353 Canwood St
Agoura Hills, CA 91301-1594 - Phone
- (747) 225-8042
- NPI assigned
- Jul 18, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 295630 | CA | Primary |
Addresses
Primary practice location
29353 Canwood St
Agoura Hills, CA 91301-1594
Mailing address
PO Box 1806
Durham, NC 27702-1806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 295630 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658102400000",
"number": "1609501352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1806",
"city": "DURHAM",
"state": "NC",
"postal_code": "277021806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29353 CANWOOD ST",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913011594",
"telephone_number": "747-225-8042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "THOMAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-18",
"last_updated": "2022-07-18",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "295630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agoura Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.