NPIMap

Organization Active NPI

Taylor & Thornburg Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Oakland, CA
National Provider Identifier
1679759203
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
TAYLOR & THORNBURG PHYSICAL THERAPY, INC.
Practice address
3718 Grand Ave
Suite 15
Oakland, CA 94610-1544
Phone
(510) 893-8878
Fax
(510) 893-8879
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Authorized official

Name
Mrs. Kathryn Smith Thornburg, P.T.NPI 1447227897
Title
Officer of Corporation
Phone
(510) 893-8878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

3718 Grand Ave
Suite 15
Oakland, CA 94610-1544

Mailing address

3718 Grand Ave
Suite 15
Oakland, CA 94610-1544
Phone (510) 893-8878

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ 07432 ZOtherMEDICARE PTAN

Other names 1

  • Fyzical Therapy & Balance CTR Oakland Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080515000229 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4789753880 Receives reassigned benefits from 14 practitioners
Practice locations: Oakland, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1679759203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3718 GRAND AVE",
            "address_2": "SUITE 15",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101544",
            "telephone_number": "510-893-8878",
            "fax_number": "510-893-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 GRAND AVE",
            "address_2": "SUITE 15",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101544",
            "telephone_number": "510-893-8878",
            "fax_number": "510-893-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR & THORNBURG PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "THORNBURG",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "OFFICER OF CORPORATION",
        "authorized_official_telephone_number": "510-893-8878",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ 07432 Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy & Balance CTR Oakland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.