Individual provider Active NPI

Tiffany Lynn Panick, P.T.

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1619236346
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38977 Issued in CA
Practice address
35 Berlamo
Rancho Santa Margarita, CA 92688-2656
Phone
(949) 635-6995
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 38977 CA Primary

Addresses

Primary practice location

35 Berlamo
Rancho Santa Margarita, CA 92688-2656

Mailing address

35 Berlamo
Rancho Santa Margarita, CA 92688-2656
Phone (949) 635-6995

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

LicenseStateTypeSpecialty
38977CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1619236346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BERLAMO",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882656",
            "telephone_number": "949-635-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BERLAMO",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882656",
            "telephone_number": "949-635-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICK",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.