Antioch Physical Therapy and Sports Injury Center Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ANTIOCH PHYSICAL THERAPY AND SPORTS INJURY CENTER INC.

Practice address

4041 Lone Tree Way Ste 106
Antioch, CA 94531-6208

Phone

(925) 754-6262

Fax

(925) 754-2198

NPI assigned

Jan 10, 2018

Organization subpart

No

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

Authorized official

Name

Randy CouchNPI 1275605255

Title

Owner/Manager

Phone

(925) 754-6262

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Randy Dale Couch, P.T.

  • Physical Therapist
  • Antioch, CA
  • NPI 1275605255

  CA

  Medicare reassignment Authorized official
• Norman Greg Hart, P.T.

  • Physical Therapist
  • Brentwood, CA
  • NPI 1568534550

  CA

  Medicare reassignment

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1689181778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 LONE TREE WAY STE 106",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316208",
            "telephone_number": "925-754-6262",
            "fax_number": "925-754-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 LONE TREE WAY STE 106",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316208",
            "telephone_number": "925-754-6262",
            "fax_number": "925-754-2198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Walnut Blvd Ste A2",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945132417",
            "country_code": "US",
            "telephone_number": "925-516-1949",
            "fax_number": "925-519-1864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANTIOCH PHYSICAL THERAPY AND SPORTS INJURY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "925-754-6262"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antioch Icf, Inc
• Antioch Medical and Hospital Supply, Inc.
• Antioch Medical Park Medical Group
• Antioch Medical Park Medical Lab
• Antioch Optometry, PC
• Antioch Rehab
• Antioch Unified School District
• Cindy Johntell Antone
• Anw Home Care Services LLC
• Alia Anwar

• All providers in Antioch, CA
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.