Xcel Orthopaedic Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

XCEL ORTHOPAEDIC PHYSICAL THERAPY, INC.

Practice address

1429 W Fremont St
Stockton, CA 95203-2627

Phone

(209) 546-0944

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Devra Bommarito

Title

President

Phone

(209) 546-0944

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1629193305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 W FREMONT ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032627",
            "telephone_number": "209-546-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 W FREMONT ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032627",
            "telephone_number": "209-546-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XCEL ORTHOPAEDIC PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "BOMMARITO",
        "authorized_official_first_name": "DEVRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-546-0944"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "15780",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "ZZZ51476Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yi-PO Anthony Wu, M.D.
• Jessica Rose Wulsin, MA
• Elizabeth Wyllie, AUD
• Kaitlin Xavier, RD
• Karuna Xaymountry, DPM
• Alan Xie
• Dangci Xie, MD
• Caroline Xiong
• Cathy Xiong
• Cho Xiong I, MSW

• Physical Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.