Individual provider Active NPI

Charmayne Yvonne Cahn, PHYSICAL THERAPIST

  • Specialist
  • Inglewood, CA
National Provider Identifier
1700336948
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT18887 Issued in CA
Practice address
323 N Prairie Ave Ste 425
Inglewood, CA 90301-4506
Phone
(310) 412-0011
Fax
(310) 412-0051
NPI assigned
Oct 12, 2016
Last updated
Oct 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT18887 CA Primary

Addresses

Primary practice location

323 N Prairie Ave Ste 425
Inglewood, CA 90301-4506

Mailing address

323 N Prairie Ave Ste 425
Inglewood, CA 90301-4506
Phone (310) 412-0011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170118002676 CA Practitioner - Physical Therapist in Private Practice 9830252634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Life Physical Therapy Services PCGroup PAC ID 7214207125, 94 clinicians

Practice addresses (Care Compare)

201 N Crescent Dr
Beverly Hills, CA 90210-4898
Phone (424) 313-5988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18887CAMDMarriage & Family Therapist
PT18887CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Physical Therapy Services, PC CurrentSince Jul 25, 2020 Accepting new patients
Qarmon PC Past Accepting new patients
Trellis Physical Therapy a Professional Rehab Group Inc. PastSince Jul 25, 2020 Accepting new patients

Locations

1837 Pacific Coast Hwy
Hermosa Beach, CA 90254
Phone (310) 482-2733

17122 Beach Blvd
Ste 101
Huntington Beach, CA 92647
Phone (714) 848-7191

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jola Home Health ServicesInglewood, CA, CCN 058004 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director
W-2 Managing Employee
Apr 18, 2012
Sep 24, 2008
Sep 24, 2008
Sep 24, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1700336948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE STE 425",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014506",
            "telephone_number": "310-412-0011",
            "fax_number": "310-412-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE STE 425",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014506",
            "telephone_number": "310-412-0011",
            "fax_number": "310-412-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHN",
        "first_name": "CHARMAYNE",
        "middle_name": "YVONNE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT18887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.