Adam Fetter

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

5 Bon Air Rd Ste 129
Larkspur, CA 94939-1139

Phone

(415) 924-8900

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1669951802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 129",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 129",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391139",
            "telephone_number": "415-924-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTER",
        "first_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.