Active NPI
Carl Timothy Brater, P.T.
- Physical Therapist
- Eureka, CA
National Provider Identifier
1710053269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT22790
- Practice address
- 2121 Myrtle Ave.
Eureka, CA 95501 - Phone
- (707) 442-6463
- Fax
- (707) 442-5427
- NPI assigned
- Nov 27, 2006
- 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 | PT22790 | CA | Primary |
Addresses
Primary practice location
2121 Myrtle Ave.
Eureka, CA 95501
Mailing address
2121 Myrtle Ave
Eureka, CA 95501
Phone (707) 442-6463
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 |
|---|---|---|---|
| PT22790 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1710053269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 MYRTLE AVE",
"city": "EUREKA",
"state": "CA",
"postal_code": "95501",
"telephone_number": "707-442-6463",
"fax_number": "707-442-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 MYRTLE AVE.",
"city": "EUREKA",
"state": "CA",
"postal_code": "95501",
"telephone_number": "707-442-6463",
"fax_number": "707-442-5427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRATER",
"first_name": "CARL",
"middle_name": "TIMOTHY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT22790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.