Mary M Powell-Penrith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 11967 Issued in CA

Practice address

8344 Clairemont Mesa Blvd
Suite 110
San Diego, CA 92111-1307

Phone

(858) 736-6672

Fax

(858) 565-6911

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Mary M Lake Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1982

Medicare assignment

May accept Medicare assignment

Group practices

PT in MotionGroup PAC ID 7315997285, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• PT in Motion

  • Pediatric Occupational Therapist
  • San Diego, CA
  • NPI 1699884221

  Orthopedic

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1609937978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 GIRARD AVE",
            "address_2": "SUITE 1-513",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375149",
            "telephone_number": "858-736-6672",
            "fax_number": "858-565-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8344 CLAIREMONT MESA BLVD",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111307",
            "telephone_number": "858-736-6672",
            "fax_number": "858-565-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL-PENRITH",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "CA",
            "license": "PT 11967",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 11967",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 11967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LAKE",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pouya Afshar MD Inc (Integrated Healthcare Alliance Inc.)
• Pouya Afshar MD Inc
• Aaron Michael Povio
• Haley Rose Povondra
• Poway Unified School District
• Aimee Powell, M.A., CCC-SLP
• Ashley Powell, PT
• Blake Powell, RRT
• Brittanni Powell, PPS
• Brittany Elizabeth Powell

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.