Individual provider Active NPI

Halsey Corbett, P.T.

  • Physical Therapist
  • Manteca, CA
National Provider Identifier
1639197825
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6471 Issued in CA
Practice address
1191 E Yosemite Ave
Manteca, CA 95336-5011
Phone
(209) 824-9888
Fax
(209) 824-9469
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT6471 CA Primary

Addresses

Primary practice location

1191 E Yosemite Ave
Manteca, CA 95336-5011

Mailing address

220 Standiford Ave
Ste F
Modesto, CA 95350-1159
Phone (209) 579-5628

Other identifiers 1

IdentifierTypeStateIssuer
00PT64710OtherCABLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6471CAMDPhysical Therapist
6471CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Motus Physical Therapy and Performance Inc Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
County of Stanislaus Current Accepting new patients

Locations

1191 E Yosemite Ave
Ste A
Manteca, CA 95336
Phone (209) 824-9469

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639197825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STANDIFORD AVE",
            "address_2": "STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501159",
            "telephone_number": "209-579-5628",
            "fax_number": "209-579-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 E YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365011",
            "telephone_number": "209-824-9888",
            "fax_number": "209-824-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "HALSEY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00PT64710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.