Organization Active NPI

Agile Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Palo Alto, CA
National Provider Identifier
1659445443
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT17712 Issued in CA
Legal business name
AGILE PHYSICAL THERAPY INC
Practice address
2450 El Camino Real
Suite 101
Palo Alto, CA 94306-1706
Phone
(650) 565-8090
Fax
(650) 565-8095
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Miss Christina Cole
Title
Bookkeeper
Phone
(650) 565-8090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT17712 CA Primary

Addresses

Primary practice location

2450 El Camino Real
Suite 101
Palo Alto, CA 94306-1706

Mailing address

2450 El Camino Real
Suite 101
Palo Alto, CA 94306-1706
Phone (650) 565-8090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312001327 CA Part B Supplier - Clinic/Group Practice 2163311556 Receives reassigned benefits from 66 practitioners
Practice locations: San Mateo, CA; San Francisco, CA; Menlo Park, CA; Redwood City, CA; Palo Alto, CA; Los Altos, CA; Los Angeles, CA; Los Gatos, CA

National Provider Directory

National Provider Directory

Locations

600 Fremont Ave
Los Altos, CA 94024
Phone (408) 504-1617

1620 El Camino Real
#1618
Menlo Park, CA 94025

873 El Camino Real
Menlo Park, CA 94025
Phone (650) 419-7564

2450 El Camino Real
Ste 101
Palo Alto, CA 94306

2450 El Camino Real
Ste 100
Palo Alto, CA 94306

3825 El Camino Real
Palo Alto, CA 94306
Phone (856) 296-2860

77 Battery St
Ste 400
San Francisco, CA 94111

1670 S Amphlett Blvd
Ste 123
San Mateo, CA 94402
Phone (650) 558-0247

801 N San Mateo Dr
San Mateo, CA 94401

Practitioners & affiliated clinicians

Practitioners 120

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1659445443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061706",
            "telephone_number": "650-565-8090",
            "fax_number": "650-565-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061706",
            "telephone_number": "650-565-8090",
            "fax_number": "650-565-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGILE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "650-565-8090",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT17712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.