Water'S Edge Physical Therapy and Wellness, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

35208 Issued in CA

Legal business name

WATER'S EDGE PHYSICAL THERAPY AND WELLNESS, INC.

Practice address

1228 N Coast Highway 101 Ste 120
1230 N Coast Highway 101 Suite 130
Encinitas, CA 92024-1493

Phone

(760) 479-9801

NPI assigned

Aug 18, 2013

Organization subpart

No

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

Authorized official

Name

Shane Carpenter, DPTNPI 1992943823

Title

President/ PT, DPT

Phone

(831) 419-8856

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.

• Shane C Carpenter, DPT

  • Physical Therapist
  • Cardiff, CA
  • NPI 1992943823
  NPD (past) Authorized official

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

{
    "created_epoch": "1376784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376784000000",
    "number": "1679906242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 SAN ELIJO AVE",
            "address_2": "111",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 N COAST HIGHWAY 101 STE 120",
            "address_2": "1230 N COAST HIGHWAY 101 SUITE 130",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241493",
            "telephone_number": "760-479-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER'S EDGE PHYSICAL THERAPY AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-18",
        "last_updated": "2013-08-18",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT/ PT, DPT",
        "authorized_official_telephone_number": "831-419-8856",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "35208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Warfield, PH.D
• Warner Occupational Therapy, Inc.
• Douglas D Warner, D.D.S M.S
• Lindsay Caren Wasserman-Hallock, F.N.P.
• Connor Wasson
• William L. Waters, P.T.
• Wave Wellness Clinic Professional Corporation
• Celina Ranae Wayment
• Richard Alan Weber Jr., MA
• Corey John Wehr, NP

• Physical Therapy Clinic/Center in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2013; 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.