Provoke SF

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

43538 Issued in CA

Legal business name

PROVOKE SF

Practice address

80 Missouri St
San Francisco, CA 94107-2454

Phone

(631) 255-5044

Fax

(415) 484-7274

NPI assigned

Apr 5, 2017

Last updated

Apr 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian M King, DPTNPI 1982093134

Title

Owner

Phone

(631) 255-5044

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Brian M King, PT, DPT

  • Orthopedic Physical Therapist
  • San Francisco, CA
  • NPI 1982093134
  NPD Authorized official

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1649703893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 SANCHEZ ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MISSOURI ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941072454",
            "telephone_number": "631-255-5044",
            "fax_number": "415-484-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVOKE SF",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-255-5044",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "43538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Proudfoot, MS CF-SLP
• Olivia Provan, MFT
• Heather Lynne Provencher, M.D.
• Celina Provencio
• Providence Foundation of San Francisco
• Madeleine Prowda
• Sally L Prowitt
• Cecillia Prue
• Connor Evan Pruitt
• Cotelia P Pruitt

• Orthopedic Physical Therapist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.