NPIMap

Organization Active NPI

Clinical Therapeutics Inc

Doing business as CTI Physical Therapy

  • Physical Therapist
  • Warren, PA
National Provider Identifier
1629009048
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CLINICAL THERAPEUTICS INC
Doing business as
CTI Physical Therapy
Practice address
2265 Market Street
Suite a
Warren, PA 16365-4682
Phone
(814) 726-9050
Fax
(814) 726-9629
NPI assigned
Jul 5, 2006
Last updated
Dec 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Authorized official

Name
Carl Andrew Sandstrom, MSPTNPI 1952387045
Title
Owner/Director
Phone
(814) 726-9050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Clinical Electrophysiology Physical Therapist 2251E1300X

Addresses

Primary practice location

2265 Market Street
Suite a
Warren, PA 16365-4682

Mailing address

2265 Market Street
Suite a
Warren, PA 16365-4682
Phone (814) 726-9050

Other identifiers 1

IdentifierTypeStateIssuer
1007362470012MedicaidPA

Other names 1

  • CTI Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050420000275 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981642014 Receives reassigned benefits from 2 practitioners
Practice locations: Erie, PA; Warren, PA

National Provider Directory

National Provider Directory

Locations

300 State St
Ste 104
Erie, PA 16507
Phone (814) 454-5251

300 State St
Ste 205
Erie, PA 16507
Phone (814) 456-6022

300 State St
Ste 209
Erie, PA 16507
Phone (814) 454-5251

2265 Market St
Ste A
Warren, PA 16365
Phone (814) 726-9050

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1629009048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 MARKET STREET",
            "address_2": "SUITE A",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163654682",
            "telephone_number": "814-726-9050",
            "fax_number": "814-726-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 MARKET STREET",
            "address_2": "SUITE A",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163654682",
            "telephone_number": "814-726-9050",
            "fax_number": "814-726-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "SANDSTROM",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "814-726-9050",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007362470012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CTI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.