Active NPI
Leo J Castleberry, PT
- Physical Therapist
- Groveland, CA
National Provider Identifier
1689850786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT12522
- Practice address
- 18687 Main Street
Groveland, CA 95321 - Phone
- (209) 962-4035
- Fax
- (209) 962-5399
- NPI assigned
- Jan 18, 2008
- Last updated
- Jan 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT12522 | CA | Primary |
Addresses
Primary practice location
18687 Main Street
Groveland, CA 95321
Mailing address
PO Box 737
Groveland, CA 95321-0737
Phone (209) 962-4035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT12522 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Tuolumne | Past | Accepting new patients | |
| County of Tuolumne | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tuolumne County Behavioral Health
- Community/Behavioral Health Agency
- Sonora, CA
- NPI 1366618035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1689850786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 737",
"city": "GROVELAND",
"state": "CA",
"postal_code": "953210737",
"telephone_number": "209-962-4035",
"fax_number": "209-962-5399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18687 MAIN STREET",
"city": "GROVELAND",
"state": "CA",
"postal_code": "95321",
"telephone_number": "209-962-4035",
"fax_number": "209-962-5399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTLEBERRY",
"first_name": "LEO",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-18",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT12522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groveland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.