Individual provider Active NPI

Winter Anne Ives, DPT

  • Physical Therapist
  • Lodi, CA
National Provider Identifier
1639938715
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6356 Issued in NV
Practice address
631 S Ham LN # B
Lodi, CA 95242-3532
Phone
(120) 936-8743
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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 6356 NV Primary

Addresses

Primary practice location

631 S Ham LN # B
Lodi, CA 95242-3532

Mailing address

7487 E Kettleman LN
Lodi, CA 95240-9451
Phone (510) 520-0555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260313003277 CA Practitioner - Physical Therapist in Private Practice 1153804497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

631 S Ham LN
Suite B
Lodi, CA 95242-3532
Phone (209) 368-7433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6356NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speakeasy Therapy Services, LLC CurrentSince Mar 24, 2024 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Jan 28, 2026 Accepting new patients
Speakeasy Therapy Services, LLC Physical Therapist CurrentSince Aug 18, 2024 Accepting new patients

Locations

631 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 368-7433

6345 S Jones Blvd
Ste 300
Las Vegas, NV 89118
Phone (702) 515-7009

Organizations & group practices 3

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1639938715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7487 E KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952409451",
            "telephone_number": "510-520-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S HAM LN # B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423532",
            "telephone_number": "120-936-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "WINTER",
        "middle_name": "ANNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "6356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.